- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,697.09 / $31,563.80 / $55,543.20
| Facility | | $18,697.09 | $31,563.80 | $55,543.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,907.77 / $17,475.34 / $28,825.28
| Facility | | $11,907.77 | $17,475.34 | $28,825.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,007.95 / $28,611.78 / $39,257.90
| Facility | | $17,007.95 | $28,611.78 | $39,257.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59,844.95 / $59,844.95 / $70,233.13
| Facility | | $59,844.95 | $59,844.95 | $70,233.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $27,507.60 / $39,291.46
| Facility | | $1,787.00 | $27,507.60 | $39,291.46 |