- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,118.86 / $25,703.96 / $25,703.96
| Facility | | $25,118.86 | $25,703.96 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,307.81 / $47,863.01 / $72,443.60
| Facility | | $36,307.81 | $47,863.01 | $72,443.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $37,153.52 / $50,118.72
| Facility | | $19,952.62 | $37,153.52 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,547.09 / $24,547.09 / $41,686.94
| Facility | | $24,547.09 | $24,547.09 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $27,542.29 / $85,113.80
| Facility | | $10,715.19 | $27,542.29 | $85,113.80 |