- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,863.40 / $25,601.30 / $52,028.60
| Facility | | $19,863.40 | $25,601.30 | $52,028.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,784.54 / $28,784.54 / $28,784.54
| Facility | | $28,784.54 | $28,784.54 | $28,784.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,637.82 / $22,109.38 / $25,276.74
| Facility | | $17,637.82 | $22,109.38 | $25,276.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,855.27 / $28,065.49 / $36,500.37
| Facility | | $15,855.27 | $28,065.49 | $36,500.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,102.22 / $33,102.22 / $33,102.22
| Facility | | $33,102.22 | $33,102.22 | $33,102.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $25,501.48 / $35,851.75
| Facility | | $1,518.00 | $25,501.48 | $35,851.75 |