- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $26,302.68 / $72,443.60
| Facility | | $16,982.44 | $26,302.68 | $72,443.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $33,113.11 / $52,480.75
| Facility | | $22,908.68 | $33,113.11 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $35,481.34 / $47,863.01
| Facility | | $21,877.62 | $35,481.34 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104,712.85 / $104,712.85 / $104,712.85
| Facility | | $104,712.85 | $104,712.85 | $104,712.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $37,153.52 / $56,234.13
| Facility | | $2,951.21 | $37,153.52 | $56,234.13 |