- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $30,902.95 / $51,286.14
| Facility | | $14,791.08 | $30,902.95 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $28,183.83 / $75,857.76
| Facility | | $6,165.95 | $28,183.83 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $28,840.32 / $41,686.94
| Facility | | $18,620.87 | $28,840.32 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,657.95 / $42,657.95 / $42,657.95
| Facility | | $42,657.95 | $42,657.95 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $27,542.29 / $75,857.76
| Facility | | $6,165.95 | $27,542.29 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $28,183.83 / $75,857.76
| Facility | | $6,165.95 | $28,183.83 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $22,908.68 / $64,565.42
| Facility | | $6,165.95 | $22,908.68 | $64,565.42 |