- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,739.59 / $31,510.10 / $61,610.70
| Facility | | $20,739.59 | $31,510.10 | $61,610.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,682.52 / $22,646.01 / $36,945.85
| Facility | | $15,682.52 | $22,646.01 | $36,945.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,865.88 / $31,737.29 / $43,546.39
| Facility | | $18,865.88 | $31,737.29 | $43,546.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66,962.85 / $66,962.85 / $78,586.59
| Facility | | $66,962.85 | $66,962.85 | $78,586.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,158.00 / $31,205.00 / $51,036.16
| Facility | | $3,158.00 | $31,205.00 | $51,036.16 |