- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $42,657.95 / $69,183.10
| Facility | | $28,183.83 | $42,657.95 | $69,183.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $30,199.52 / $51,286.14
| Facility | | $14,454.40 | $30,199.52 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,302.68 / $43,651.58 / $83,176.38
| Facility | | $26,302.68 | $43,651.58 | $83,176.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104,712.85 / $104,712.85 / $104,712.85
| Facility | | $104,712.85 | $104,712.85 | $104,712.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $39,810.72 / $69,183.10
| Facility | | $16,218.10 | $39,810.72 | $69,183.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,302.68 / $36,307.81 / $89,125.09
| Facility | | $26,302.68 | $36,307.81 | $89,125.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $35,481.34 / $81,283.05
| Facility | | $7,079.46 | $35,481.34 | $81,283.05 |