- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $25,703.96 / $48,977.88
| Facility | | $16,595.87 | $25,703.96 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,199.52 / $30,199.52 / $30,199.52
| Facility | | $30,199.52 | $30,199.52 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $21,877.62 / $35,481.34
| Facility | | $14,454.40 | $21,877.62 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $15,488.17 / $34,673.69
| Facility | | $6,309.57 | $15,488.17 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $22,908.68 / $32,359.37
| Facility | | $6,456.54 | $22,908.68 | $32,359.37 |