- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $28,183.83 / $33,884.42
| Facility | | $21,877.62 | $28,183.83 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,902.95 / $30,902.95 / $30,902.95
| Facility | | $30,902.95 | $30,902.95 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $29,512.09 / $52,480.75
| Facility | | $12,302.69 | $29,512.09 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151,356.12 / $151,356.12 / $151,356.12
| Facility | | $151,356.12 | $151,356.12 | $151,356.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $33,884.42 / $53,703.18
| Facility | | $25,703.96 | $33,884.42 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $30,902.95 / $48,977.88
| Facility | | $16,218.10 | $30,902.95 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $28,840.32 / $43,651.58
| Facility | | $18,197.01 | $28,840.32 | $43,651.58 |