- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $14,125.38 / $24,547.09
| Facility | | $14,125.38 | $14,125.38 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,542.29 / $37,153.52 / $54,954.09
| Facility | | $27,542.29 | $37,153.52 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $28,840.32 / $38,018.94
| Facility | | $15,135.61 | $28,840.32 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $18,620.87 / $32,359.37
| Facility | | $18,620.87 | $18,620.87 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,307.81 / $36,307.81 / $64,565.42
| Facility | | $36,307.81 | $36,307.81 | $64,565.42 |