- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,402.80 / $29,866.20 / $38,994.50
| Facility | | $14,402.80 | $29,866.20 | $38,994.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,273.97 / $73,034.35
| Facility | | $5,840.42 | $27,273.97 | $73,034.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,875.40 / $27,903.84 / $42,163.03
| Facility | | $16,875.40 | $27,903.84 | $42,163.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,626.32 / $39,626.32 / $39,626.32
| Facility | | $39,626.32 | $39,626.32 | $39,626.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,314.15 / $28,110.60 / $43,409.37
| Facility | | $24,314.15 | $28,110.60 | $43,409.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,273.97 / $73,034.35
| Facility | | $5,840.42 | $27,273.97 | $73,034.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,273.97 / $57,076.99
| Facility | | $5,840.42 | $27,273.97 | $57,076.99 |