- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $18,197.01 / $50,118.72
| Facility | | $11,748.98 | $18,197.01 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $14,791.08 / $26,915.35
| Facility | | $14,454.40 | $14,791.08 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $21,877.62 / $33,884.42
| Facility | | $15,135.61 | $21,877.62 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $24,547.09 / $33,113.11
| Facility | | $15,848.93 | $24,547.09 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72,443.60 / $72,443.60 / $72,443.60
| Facility | | $72,443.60 | $72,443.60 | $72,443.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $25,703.96 / $38,904.51
| Facility | | $2,951.21 | $25,703.96 | $38,904.51 |