- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,798.90 / $26,671.20 / $46,933.60
| Facility | | $15,798.90 | $26,671.20 | $46,933.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,736.52 / $21,736.52 / $21,736.52
| Facility | | $21,736.52 | $21,736.52 | $21,736.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,658.62 / $19,996.81 / $33,063.61
| Facility | | $13,658.62 | $19,996.81 | $33,063.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,371.58 / $24,176.72 / $33,172.60
| Facility | | $14,371.58 | $24,176.72 | $33,172.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49,170.75 / $49,170.75 / $57,706.05
| Facility | | $49,170.75 | $49,170.75 | $57,706.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $23,243.70 / $33,200.96
| Facility | | $1,787.00 | $23,243.70 | $33,200.96 |