- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,771.30 / $26,624.60 / $46,851.60
| Facility | | $15,771.30 | $26,624.60 | $46,851.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,100.37 / $27,100.37 / $27,100.37
| Facility | | $27,100.37 | $27,100.37 | $27,100.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,202.97 / $17,621.43 / $28,665.23
| Facility | | $12,202.97 | $17,621.43 | $28,665.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,346.49 / $24,134.51 / $33,114.69
| Facility | | $14,346.49 | $24,134.51 | $33,114.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49,928.65 / $49,928.65 / $58,595.51
| Facility | | $49,928.65 | $49,928.65 | $58,595.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $23,203.12 / $33,143.01
| Facility | | $1,787.00 | $23,203.12 | $33,143.01 |