- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,777.40 / $30,643.10 / $40,008.90
| Facility | | $14,777.40 | $30,643.10 | $40,008.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,983.42 / $74,934.12
| Facility | | $5,840.42 | $27,983.42 | $74,934.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,314.36 / $28,629.67 / $43,259.78
| Facility | | $17,314.36 | $28,629.67 | $43,259.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,478.16 / $36,478.16 / $36,478.16
| Facility | | $36,478.16 | $36,478.16 | $36,478.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,946.61 / $28,841.82 / $44,538.54
| Facility | | $24,946.61 | $28,841.82 | $44,538.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,983.42 / $74,934.12
| Facility | | $5,840.42 | $27,983.42 | $74,934.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,983.42 / $58,561.68
| Facility | | $5,840.42 | $27,983.42 | $58,561.68 |