- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,136.50 / $24,516.60 / $47,936.50
| Facility | | $16,136.50 | $24,516.60 | $47,936.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,280.68 / $17,979.45 / $29,728.01
| Facility | | $12,280.68 | $17,979.45 | $29,728.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,678.70 / $24,693.37 / $33,881.50
| Facility | | $14,678.70 | $24,693.37 | $33,881.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53,386.90 / $53,386.90 / $62,654.06
| Facility | | $53,386.90 | $53,386.90 | $62,654.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $23,740.42 / $33,910.47
| Facility | | $1,787.00 | $23,740.42 | $33,910.47 |