- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,297.10 / $25,499.80 / $33,293.50
| Facility | | $12,297.10 | $25,499.80 | $33,293.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,985.75 / $62,356.72
| Facility | | $5,840.42 | $22,985.75 | $62,356.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,408.21 / $23,824.30 / $35,998.80
| Facility | | $14,408.21 | $23,824.30 | $35,998.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,832.94 / $33,832.94 / $33,832.94
| Facility | | $33,832.94 | $33,832.94 | $33,832.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,759.41 / $24,000.83 / $37,062.92
| Facility | | $20,759.41 | $24,000.83 | $37,062.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,985.75 / $62,356.72
| Facility | | $5,840.42 | $22,985.75 | $62,356.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $18,109.73 / $48,732.33
| Facility | | $5,840.42 | $18,109.73 | $48,732.33 |