- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $28,183.83 / $37,153.52
| Facility | | $17,378.01 | $28,183.83 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $23,988.33 / $23,988.33
| Facility | | $23,988.33 | $23,988.33 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,840.32 / $42,657.95 / $52,480.75
| Facility | | $28,840.32 | $42,657.95 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,884.42 / $33,884.42 / $33,884.42
| Facility | | $33,884.42 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $26,915.35 / $35,481.34
| Facility | | $17,782.79 | $26,915.35 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,884.42 / $33,884.42 / $33,884.42
| Facility | | $33,884.42 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $23,442.29 / $38,904.51
| Facility | | $15,488.17 | $23,442.29 | $38,904.51 |