- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $41,686.94 / $77,624.71
| Facility | | $26,915.35 | $41,686.94 | $77,624.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,773.51 / $46,773.51 / $46,773.51
| Facility | | $46,773.51 | $46,773.51 | $46,773.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $34,673.69 / $56,234.13
| Facility | | $22,908.68 | $34,673.69 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $25,703.96 / $56,234.13
| Facility | | $10,715.19 | $25,703.96 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $36,307.81 / $52,480.75
| Facility | | $6,606.93 | $36,307.81 | $52,480.75 |