- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,475.30 / $29,501.20 / $51,913.60
| Facility | | $17,475.30 | $29,501.20 | $51,913.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,839.34 / $30,839.34 / $30,839.34
| Facility | | $30,839.34 | $30,839.34 | $30,839.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,232.30 / $19,107.82 / $31,173.46
| Facility | | $13,232.30 | $19,107.82 | $31,173.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,896.54 / $26,742.10 / $36,692.53
| Facility | | $15,896.54 | $26,742.10 | $36,692.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56,203.85 / $56,203.85 / $65,959.99
| Facility | | $56,203.85 | $56,203.85 | $65,959.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,520.00 / $23,428.68 / $36,527.33
| Facility | | $2,520.00 | $23,428.68 | $36,527.33 |