- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,364.80 / $25,640.20 / $33,476.80
| Facility | | $12,364.80 | $25,640.20 | $33,476.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,414.73 / $62,700.05
| Facility | | $5,840.42 | $23,414.73 | $62,700.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,487.55 / $23,955.47 / $36,197.00
| Facility | | $14,487.55 | $23,955.47 | $36,197.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,019.23 / $34,019.23 / $34,019.23
| Facility | | $34,019.23 | $34,019.23 | $34,019.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,873.72 / $24,132.98 / $37,266.99
| Facility | | $20,873.72 | $24,132.98 | $37,266.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,414.73 / $62,700.05
| Facility | | $5,840.42 | $23,414.73 | $62,700.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,414.73 / $49,000.65
| Facility | | $5,840.42 | $23,414.73 | $49,000.65 |