- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,871.90 / $31,584.80 / $52,013.20
| Facility | | $12,871.90 | $31,584.80 | $52,013.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,536.48 / $54,217.61 / $70,303.55
| Facility | | $36,536.48 | $54,217.61 | $70,303.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $41,741.31 / $66,739.95
| Facility | | $17,646.00 | $41,741.31 | $66,739.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,402.01 / $44,967.53 / $94,298.33
| Facility | | $23,402.01 | $44,967.53 | $94,298.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,271.49 / $17,271.49 / $17,271.49
| Facility | | $17,271.49 | $17,271.49 | $17,271.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,648.00 / $44,670.58 / $66,756.42
| Facility | | $17,648.00 | $44,670.58 | $66,756.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $29,889.24 / $57,414.67
| Facility | | $5,281.00 | $29,889.24 | $57,414.67 |