- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,545.40 / $26,671.20 / $46,933.60
| Facility | | $13,545.40 | $26,671.20 | $46,933.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,817.66 / $47,737.41 / $77,881.23
| Facility | | $31,817.66 | $47,737.41 | $77,881.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,371.58 / $24,176.72 / $33,172.60
| Facility | | $14,371.58 | $24,176.72 | $33,172.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,909.76 / $50,286.40 / $59,015.36
| Facility | | $23,909.76 | $50,286.40 | $59,015.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,520.00 / $25,361.06 / $36,719.18
| Facility | | $2,520.00 | $25,361.06 | $36,719.18 |