- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,009.90 / $31,125.10 / $40,638.19
| Facility | | $15,009.90 | $31,125.10 | $40,638.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $28,423.62 / $76,112.89
| Facility | | $5,840.42 | $28,423.62 | $76,112.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,586.73 / $29,080.04 / $43,940.29
| Facility | | $17,586.73 | $29,080.04 | $43,940.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41,296.65 / $41,296.65 / $41,296.65
| Facility | | $41,296.65 | $41,296.65 | $41,296.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,339.04 / $29,295.52 / $45,239.16
| Facility | | $25,339.04 | $29,295.52 | $45,239.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $28,423.62 / $76,112.89
| Facility | | $5,840.42 | $28,423.62 | $76,112.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $28,423.62 / $59,482.90
| Facility | | $5,840.42 | $28,423.62 | $59,482.90 |