- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,735.90 / $28,014.60 / $56,933.20
| Facility | | $21,735.90 | $28,014.60 | $56,933.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,731.53 / $32,731.53 / $32,731.53
| Facility | | $32,731.53 | $32,731.53 | $32,731.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,641.58 / $29,635.22 / $33,880.72
| Facility | | $23,641.58 | $29,635.22 | $33,880.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,349.90 / $30,711.15 / $39,941.18
| Facility | | $17,349.90 | $30,711.15 | $39,941.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,641.26 / $37,641.26 / $37,641.26
| Facility | | $37,641.26 | $37,641.26 | $37,641.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $26,646.66 / $39,231.41
| Facility | | $1,518.00 | $26,646.66 | $39,231.41 |