- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $28,183.83 / $77,624.71
| Facility | | $18,197.01 | $28,183.83 | $77,624.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $38,904.51 / $61,659.50
| Facility | | $26,915.35 | $38,904.51 | $61,659.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,547.09 / $38,018.94 / $51,286.14
| Facility | | $24,547.09 | $38,018.94 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112,201.85 / $112,201.85 / $112,201.85
| Facility | | $112,201.85 | $112,201.85 | $112,201.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $41,686.94 / $61,659.50
| Facility | | $3,801.89 | $41,686.94 | $61,659.50 |