- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,374.50 / $31,019.30 / $54,584.90
| Facility | | $18,374.50 | $31,019.30 | $54,584.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,626.74 / $27,626.74 / $27,626.74
| Facility | | $27,626.74 | $27,626.74 | $27,626.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,354.60 / $22,758.91 / $37,630.58
| Facility | | $16,354.60 | $22,758.91 | $37,630.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,714.52 / $28,118.14 / $38,580.58
| Facility | | $16,714.52 | $28,118.14 | $38,580.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59,842.30 / $59,842.30 / $70,230.02
| Facility | | $59,842.30 | $59,842.30 | $70,230.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,520.00 / $25,278.45 / $38,406.89
| Facility | | $2,520.00 | $25,278.45 | $38,406.89 |