- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,977.90 / $28,542.50 / $47,979.10
| Facility | | $12,977.90 | $28,542.50 | $47,979.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,580.01 / $45,348.83 / $58,292.26
| Facility | | $29,580.01 | $45,348.83 | $58,292.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,556.89 / $40,508.79 / $59,464.63
| Facility | | $25,556.89 | $40,508.79 | $59,464.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,609.44 / $40,055.73 / $83,998.13
| Facility | | $22,609.44 | $40,055.73 | $83,998.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,689.48 / $14,739.71 / $17,795.74
| Facility | | $14,689.48 | $14,739.71 | $17,795.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,609.23 / $43,596.63 / $59,792.46
| Facility | | $24,609.23 | $43,596.63 | $59,792.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,207.19 / $36,343.57 / $55,475.20
| Facility | | $8,207.19 | $36,343.57 | $55,475.20 |