- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,128.40 / $27,223.60 / $35,544.19
| Facility | | $13,128.40 | $27,223.60 | $35,544.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,539.60 / $66,572.07
| Facility | | $5,840.42 | $24,539.60 | $66,572.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,545.29 / $24,171.38 / $35,264.98
| Facility | | $16,545.29 | $24,171.38 | $35,264.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,120.08 / $36,120.08 / $36,120.08
| Facility | | $36,120.08 | $36,120.08 | $36,120.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,162.77 / $25,623.30 / $39,568.40
| Facility | | $22,162.77 | $25,623.30 | $39,568.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,539.60 / $66,572.07
| Facility | | $5,840.42 | $24,539.60 | $66,572.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,333.96 / $52,026.67
| Facility | | $5,840.42 | $19,333.96 | $52,026.67 |