- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $26,915.35 / $144,543.98
| Facility | | $18,620.87 | $26,915.35 | $144,543.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $12,302.69 / $25,703.96
| Facility | | $12,302.69 | $12,302.69 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $26,302.68 / $47,863.01
| Facility | | $13,803.84 | $26,302.68 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $26,915.35 / $38,018.94
| Facility | | $15,488.17 | $26,915.35 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $40,738.03 / $63,095.73
| Facility | | $21,877.62 | $40,738.03 | $63,095.73 |