- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $25,118.86 / $40,738.03
| Facility | | $17,782.79 | $25,118.86 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $27,542.29 / $37,153.52
| Facility | | $26,915.35 | $27,542.29 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $17,782.79 / $30,902.95
| Facility | | $8,912.51 | $17,782.79 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $26,915.35 / $48,977.88
| Facility | | $15,848.93 | $26,915.35 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63,095.73 / $63,095.73 / $63,095.73
| Facility | | $63,095.73 | $63,095.73 | $63,095.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $24,547.09 / $40,738.03
| Facility | | $9,549.93 | $24,547.09 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $22,908.68 / $52,480.75
| Facility | | $15,488.17 | $22,908.68 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $21,379.62 / $47,863.01
| Facility | | $7,079.46 | $21,379.62 | $47,863.01 |