- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $28,183.83 / $77,624.71
| Facility | | $18,197.01 | $28,183.83 | $77,624.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $30,199.52 / $46,773.51
| Facility | | $20,892.96 | $30,199.52 | $46,773.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,547.09 / $38,018.94 / $51,286.14
| Facility | | $24,547.09 | $38,018.94 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112,201.85 / $112,201.85 / $112,201.85
| Facility | | $112,201.85 | $112,201.85 | $112,201.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $39,810.72 / $60,255.96
| Facility | | $2,951.21 | $39,810.72 | $60,255.96 |