- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $21,877.62 / $46,773.51
| Facility | | $10,232.93 | $21,877.62 | $46,773.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,302.68 / $39,810.72 / $48,977.88
| Facility | | $26,302.68 | $39,810.72 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $28,840.32 / $39,810.72
| Facility | | $15,488.17 | $28,840.32 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $29,512.09 / $74,131.02
| Facility | | $16,595.87 | $29,512.09 | $74,131.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $19,498.45 / $39,810.72
| Facility | | $6,025.60 | $19,498.45 | $39,810.72 |