- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,615.70 / $38,179.10 / $67,184.10
| Facility | | $22,615.70 | $38,179.10 | $67,184.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,467.88 / $43,467.88 / $43,467.88
| Facility | | $43,467.88 | $43,467.88 | $43,467.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,128.37 / $28,475.98 / $46,821.20
| Facility | | $19,128.37 | $28,475.98 | $46,821.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,572.53 / $34,608.32 / $47,485.69
| Facility | | $20,572.53 | $34,608.32 | $47,485.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,416.90 / $72,384.75 / $84,949.65
| Facility | | $34,416.90 | $72,384.75 | $84,949.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,520.00 / $30,320.26 / $47,271.90
| Facility | | $2,520.00 | $30,320.26 | $47,271.90 |