- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,569.30 / $29,082.50 / $59,116.10
| Facility | | $22,569.30 | $29,082.50 | $59,116.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,187.35 / $28,187.35 / $28,187.35
| Facility | | $28,187.35 | $28,187.35 | $28,187.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,575.16 / $28,298.44 / $32,352.43
| Facility | | $22,575.16 | $28,298.44 | $32,352.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,015.14 / $29,671.44 / $40,786.03
| Facility | | $18,015.14 | $29,671.44 | $40,786.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,415.45 / $32,415.45 / $32,415.45
| Facility | | $32,415.45 | $32,415.45 | $32,415.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $28,975.40 / $42,792.26
| Facility | | $1,518.00 | $28,975.40 | $42,792.26 |