- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,208.20 / $30,738.50 / $54,090.90
| Facility | | $18,208.20 | $30,738.50 | $54,090.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,018.65 / $35,018.65 / $35,018.65
| Facility | | $35,018.65 | $35,018.65 | $35,018.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,644.62 / $23,703.70 / $38,833.19
| Facility | | $16,644.62 | $23,703.70 | $38,833.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,563.24 / $27,863.65 / $38,231.40
| Facility | | $16,563.24 | $27,863.65 | $38,231.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59,601.15 / $59,601.15 / $69,947.00
| Facility | | $59,601.15 | $59,601.15 | $69,947.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $26,788.35 / $38,264.08
| Facility | | $1,787.00 | $26,788.35 | $38,264.08 |