- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $22,908.68 / $63,095.73
| Facility | | $14,791.08 | $22,908.68 | $63,095.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $28,840.32 / $45,708.82
| Facility | | $19,952.62 | $28,840.32 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $30,902.95 / $41,686.94
| Facility | | $19,054.61 | $30,902.95 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91,201.08 / $91,201.08 / $91,201.08
| Facility | | $91,201.08 | $91,201.08 | $91,201.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $28,183.83 / $47,863.01
| Facility | | $3,801.89 | $28,183.83 | $47,863.01 |