- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,434.62 / $24,713.40 / $65,661.20
| Facility | | $17,434.62 | $24,713.40 | $65,661.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,960.62 / $23,960.62 / $23,960.62
| Facility | | $23,960.62 | $23,960.62 | $23,960.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,514.07 / $22,117.01 / $37,381.01
| Facility | | $14,514.07 | $22,117.01 | $37,381.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,280.30 / $26,332.62 / $37,863.10
| Facility | | $21,280.30 | $26,332.62 | $37,863.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,228.75 / $25,295.49 / $64,604.03
| Facility | | $13,228.75 | $25,295.49 | $64,604.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,722.88 / $25,240.46 / $35,474.22
| Facility | | $12,722.88 | $25,240.46 | $35,474.22 |