- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,110.30 / $25,508.70 / $44,887.90
| Facility | | $15,110.30 | $25,508.70 | $44,887.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,426.24 / $47,979.27 / $79,370.88
| Facility | | $32,426.24 | $47,979.27 | $79,370.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,745.18 / $23,122.94 / $31,817.65
| Facility | | $13,745.18 | $23,122.94 | $31,817.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44,217.90 / $44,217.90 / $51,893.46
| Facility | | $44,217.90 | $44,217.90 | $51,893.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $22,230.59 / $31,753.85
| Facility | | $1,787.00 | $22,230.59 | $31,753.85 |