- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,497.30 / $32,852.80 / $43,179.90
| Facility | | $22,497.30 | $32,852.80 | $43,179.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,906.61 / $22,906.61 / $22,906.61
| Facility | | $22,906.61 | $22,906.61 | $22,906.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,473.86 / $23,077.51 / $39,032.50
| Facility | | $8,473.86 | $23,077.51 | $39,032.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,679.48 / $33,150.87 / $59,131.79
| Facility | | $23,679.48 | $33,150.87 | $59,131.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,298.58 / $36,827.08 / $53,770.55
| Facility | | $28,298.58 | $36,827.08 | $53,770.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,298.58 / $34,235.69 / $53,770.55
| Facility | | $28,298.58 | $34,235.69 | $53,770.55 |