- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $30,199.52 / $48,977.88
| Facility | | $20,417.38 | $30,199.52 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $28,183.83 / $28,183.83
| Facility | | $28,183.83 | $28,183.83 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $20,892.96 / $37,153.52
| Facility | | $10,471.29 | $20,892.96 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $30,199.52 / $57,543.99
| Facility | | $19,054.61 | $30,199.52 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75,857.76 / $75,857.76 / $75,857.76
| Facility | | $75,857.76 | $75,857.76 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $28,840.32 / $48,977.88
| Facility | | $11,748.98 | $28,840.32 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $26,302.68 / $63,095.73
| Facility | | $19,054.61 | $26,302.68 | $63,095.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $25,703.96 / $57,543.99
| Facility | | $7,079.46 | $25,703.96 | $57,543.99 |