- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,630.30 / $23,010.10 / $40,491.19
| Facility | | $13,630.30 | $23,010.10 | $40,491.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,550.86 / $19,550.86 / $19,550.86
| Facility | | $19,550.86 | $19,550.86 | $19,550.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,165.90 / $23,919.77 / $38,475.37
| Facility | | $16,165.90 | $23,919.77 | $38,475.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,398.86 / $20,888.38 / $29,179.75
| Facility | | $12,398.86 | $20,888.38 | $29,179.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,039.60 / $42,039.60 / $49,337.04
| Facility | | $42,039.60 | $42,039.60 | $49,337.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,520.00 / $21,879.87 / $31,678.91
| Facility | | $2,520.00 | $21,879.87 | $31,678.91 |