- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $21,379.62 / $48,977.88
| Facility | | $15,488.17 | $21,379.62 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $20,892.96 / $38,018.94
| Facility | | $8,912.51 | $20,892.96 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151,356.12 / $151,356.12 / $151,356.12
| Facility | | $151,356.12 | $151,356.12 | $151,356.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $19,952.62 / $38,018.94
| Facility | | $15,135.61 | $19,952.62 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $19,952.62 / $45,708.82
| Facility | | $12,589.25 | $19,952.62 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $18,197.01 / $25,703.96
| Facility | | $11,481.54 | $18,197.01 | $25,703.96 |