- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,792.50 / $30,674.30 / $40,049.60
| Facility | | $14,792.50 | $30,674.30 | $40,049.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,650.11 / $75,010.41
| Facility | | $5,840.42 | $27,650.11 | $75,010.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,642.49 / $27,235.22 / $39,734.99
| Facility | | $18,642.49 | $27,235.22 | $39,734.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,698.48 / $40,698.48 / $40,698.48
| Facility | | $40,698.48 | $40,698.48 | $40,698.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,972.01 / $28,871.18 / $44,583.89
| Facility | | $24,972.01 | $28,871.18 | $44,583.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,650.11 / $75,010.41
| Facility | | $5,840.42 | $27,650.11 | $75,010.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,784.64 / $58,621.30
| Facility | | $5,840.42 | $21,784.64 | $58,621.30 |