- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,118.86 / $32,359.37 / $37,153.52
| Facility | | $25,118.86 | $32,359.37 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $11,748.98 / $11,748.98
| Facility | | $11,748.98 | $11,748.98 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $30,199.52 / $36,307.81
| Facility | | $25,703.96 | $30,199.52 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $37,153.52 / $46,773.51
| Facility | | $22,908.68 | $37,153.52 | $46,773.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $13,489.63 / $13,489.63
| Facility | | $13,489.63 | $13,489.63 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $33,884.42 / $43,651.58
| Facility | | $1,513.56 | $33,884.42 | $43,651.58 |