- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $20,417.38 / $20,417.38
| Facility | | $19,952.62 | $20,417.38 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,199.52 / $30,199.52 / $30,199.52
| Facility | | $30,199.52 | $30,199.52 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $27,542.29 / $40,738.03
| Facility | | $20,892.96 | $27,542.29 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $45,708.82 / $63,095.73
| Facility | | $11,481.54 | $45,708.82 | $63,095.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $13,803.84 / $22,908.68
| Facility | | $13,803.84 | $13,803.84 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,442.29 / $24,547.09 / $47,863.01
| Facility | | $23,442.29 | $24,547.09 | $47,863.01 |