- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,137.40 / $22,075.40 / $35,835.30
| Facility | | $15,137.40 | $22,075.40 | $35,835.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,534.31 / $27,706.65 / $43,209.34
| Facility | | $25,534.31 | $27,706.65 | $43,209.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,307.13 / $60,145.90 / $77,110.13
| Facility | | $42,307.13 | $60,145.90 | $77,110.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,774.86 / $34,366.04 / $43,189.53
| Facility | | $17,774.86 | $34,366.04 | $43,189.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,793.40 / $23,740.50 / $37,962.10
| Facility | | $15,793.40 | $23,740.50 | $37,962.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,470.15 / $31,584.19 / $47,985.56
| Facility | | $18,470.15 | $31,584.19 | $47,985.56 |