- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $26,302.68 / $58,884.37
| Facility | | $18,197.01 | $26,302.68 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $16,218.10 / $16,218.10
| Facility | | $16,218.10 | $16,218.10 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $14,791.08 / $26,915.35
| Facility | | $9,120.11 | $14,791.08 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $26,302.68 / $37,153.52
| Facility | | $15,488.17 | $26,302.68 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $40,738.03 / $61,659.50
| Facility | | $22,387.21 | $40,738.03 | $61,659.50 |