- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $20,417.38 / $33,884.42
| Facility | | $9,772.37 | $20,417.38 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $18,197.01 / $48,977.88
| Facility | | $6,165.95 | $18,197.01 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $19,498.45 / $28,840.32
| Facility | | $11,481.54 | $19,498.45 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $28,183.83 / $28,183.83
| Facility | | $28,183.83 | $28,183.83 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $18,197.01 / $48,977.88
| Facility | | $6,165.95 | $18,197.01 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $18,197.01 / $48,977.88
| Facility | | $6,165.95 | $18,197.01 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $14,791.08 / $42,657.95
| Facility | | $6,165.95 | $14,791.08 | $42,657.95 |