- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $37,153.52 / $70,794.58
| Facility | | $13,489.63 | $37,153.52 | $70,794.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,738.03 / $60,255.96 / $74,131.02
| Facility | | $40,738.03 | $60,255.96 | $74,131.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $43,651.58 / $60,255.96
| Facility | | $15,488.17 | $43,651.58 | $60,255.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,118.86 / $44,668.36 / $112,201.85
| Facility | | $25,118.86 | $44,668.36 | $112,201.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $16,982.44 / $16,982.44
| Facility | | $16,982.44 | $16,982.44 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $29,512.09 / $60,255.96
| Facility | | $8,317.64 | $29,512.09 | $60,255.96 |