- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $26,302.68 / $60,255.96
| Facility | | $18,197.01 | $26,302.68 | $60,255.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,118.86 / $25,118.86 / $25,118.86
| Facility | | $25,118.86 | $25,118.86 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $15,488.17 / $28,840.32
| Facility | | $6,918.31 | $15,488.17 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $26,915.35 / $37,153.52
| Facility | | $15,488.17 | $26,915.35 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $40,738.03 / $61,659.50
| Facility | | $6,918.31 | $40,738.03 | $61,659.50 |