- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $19,054.61 / $52,480.75
| Facility | | $12,302.69 | $19,054.61 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,199.52 / $30,199.52 / $31,622.78
| Facility | | $30,199.52 | $30,199.52 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,442.29 / $33,884.42 / $53,703.18
| Facility | | $23,442.29 | $33,884.42 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $25,703.96 / $33,884.42
| Facility | | $16,218.10 | $25,703.96 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75,857.76 / $75,857.76 / $75,857.76
| Facility | | $75,857.76 | $75,857.76 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $26,302.68 / $38,904.51
| Facility | | $3,801.89 | $26,302.68 | $38,904.51 |