- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $7,943.28 / $74,131.02
| Facility | | $2,344.23 | $7,943.28 | $74,131.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $30,199.52 / $58,884.37
| Facility | | $22,908.68 | $30,199.52 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63,095.73 / $63,095.73 / $63,095.73
| Facility | | $63,095.73 | $63,095.73 | $63,095.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $977.24 / $50,118.72
| Facility | | $549.54 | $977.24 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,412.54 / $1,905.46
| Professional | | $1,148.15 | $1,412.54 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63,095.73 / $63,095.73 / $63,095.73
| Facility | | $63,095.73 | $63,095.73 | $63,095.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $28,183.83 / $58,884.37
| Facility | | $12,022.64 | $28,183.83 | $58,884.37 |