- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $33,113.11 / $75,857.76
| Facility | | $22,908.68 | $33,113.11 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $26,915.35 / $26,915.35
| Facility | | $26,915.35 | $26,915.35 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $26,302.68 / $45,708.82
| Facility | | $10,715.19 | $26,302.68 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $33,113.11 / $56,234.13
| Facility | | $15,848.93 | $33,113.11 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $42,657.95 / $77,624.71
| Facility | | $10,715.19 | $42,657.95 | $77,624.71 |