- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $33,884.42 / $66,069.34
| Facility | | $12,589.25 | $33,884.42 | $66,069.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,153.52 / $54,954.09 / $69,183.10
| Facility | | $37,153.52 | $54,954.09 | $69,183.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $40,738.03 / $56,234.13
| Facility | | $15,488.17 | $40,738.03 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,442.29 / $41,686.94 / $104,712.85
| Facility | | $23,442.29 | $41,686.94 | $104,712.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $14,454.40 / $14,454.40
| Facility | | $14,454.40 | $14,454.40 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $27,542.29 / $56,234.13
| Facility | | $8,317.64 | $27,542.29 | $56,234.13 |