- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,310.70 / $33,910.90 / $68,915.89
| Facility | | $26,310.70 | $33,910.90 | $68,915.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,413.82 / $27,413.82 / $27,413.82
| Facility | | $27,413.82 | $27,413.82 | $27,413.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,580.91 / $30,812.69 / $35,226.87
| Facility | | $24,580.91 | $30,812.69 | $35,226.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,001.55 / $37,174.94 / $48,347.63
| Facility | | $21,001.55 | $37,174.94 | $48,347.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,525.89 / $31,525.89 / $31,525.89
| Facility | | $31,525.89 | $31,525.89 | $31,525.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $32,255.01 / $47,488.47
| Facility | | $1,518.00 | $32,255.01 | $47,488.47 |