- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $33,884.42 / $40,738.03
| Facility | | $28,183.83 | $33,884.42 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,199.52 / $30,199.52 / $48,977.88
| Facility | | $30,199.52 | $30,199.52 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $34,673.69 / $53,703.18
| Facility | | $26,915.35 | $34,673.69 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $44,668.36 / $44,668.36
| Facility | | $21,877.62 | $44,668.36 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $38,904.51 / $57,543.99
| Facility | | $28,183.83 | $38,904.51 | $57,543.99 |