- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,773.10 / $28,560.50 / $37,289.69
| Facility | | $13,773.10 | $28,560.50 | $37,289.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,744.71 / $69,841.36
| Facility | | $5,840.42 | $25,744.71 | $69,841.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,137.62 / $26,683.91 / $40,319.71
| Facility | | $16,137.62 | $26,683.91 | $40,319.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,893.90 / $37,893.90 / $37,893.90
| Facility | | $37,893.90 | $37,893.90 | $37,893.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,251.16 / $26,881.64 / $41,511.56
| Facility | | $23,251.16 | $26,881.64 | $41,511.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,744.71 / $69,841.36
| Facility | | $5,840.42 | $25,744.71 | $69,841.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $20,283.43 / $54,581.64
| Facility | | $5,840.42 | $20,283.43 | $54,581.64 |