- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,160.70 / $27,290.60 / $35,631.80
| Facility | | $13,160.70 | $27,290.60 | $35,631.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,600.06 / $66,736.11
| Facility | | $5,840.42 | $24,600.06 | $66,736.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,420.12 / $25,497.51 / $38,527.04
| Facility | | $15,420.12 | $25,497.51 | $38,527.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,209.08 / $36,209.08 / $36,209.08
| Facility | | $36,209.08 | $36,209.08 | $36,209.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,217.38 / $25,686.44 / $39,665.90
| Facility | | $22,217.38 | $25,686.44 | $39,665.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,600.06 / $66,736.11
| Facility | | $5,840.42 | $24,600.06 | $66,736.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,381.59 / $52,154.86
| Facility | | $5,840.42 | $19,381.59 | $52,154.86 |