- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $27,542.29 / $72,443.60
| Facility | | $13,803.84 | $27,542.29 | $72,443.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $38,904.51 / $60,255.96
| Facility | | $26,915.35 | $38,904.51 | $60,255.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $34,673.69 / $45,708.82
| Facility | | $21,877.62 | $34,673.69 | $45,708.82 |
- 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
- $4,073.80 / $38,904.51 / $57,543.99
| Facility | | $4,073.80 | $38,904.51 | $57,543.99 |