- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $23,442.29 / $46,773.51
| Facility | | $10,232.93 | $23,442.29 | $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 / $75,857.76
| Facility | | $16,595.87 | $29,512.09 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $11,220.18 / $11,481.54
| Facility | | $11,220.18 | $11,220.18 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $19,952.62 / $39,810.72
| Facility | | $7,762.47 | $19,952.62 | $39,810.72 |