- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $24,547.09 / $31,622.78
| Facility | | $21,379.62 | $24,547.09 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $25,703.96 / $43,651.58
| Facility | | $10,964.78 | $25,703.96 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151,356.12 / $151,356.12 / $151,356.12
| Facility | | $151,356.12 | $151,356.12 | $151,356.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $29,512.09 / $43,651.58
| Facility | | $22,908.68 | $29,512.09 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $28,183.83 / $43,651.58
| Facility | | $14,125.38 | $28,183.83 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $25,703.96 / $38,018.94
| Facility | | $16,982.44 | $25,703.96 | $38,018.94 |