- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,220.40 / $29,070.90 / $51,156.50
| Facility | | $17,220.40 | $29,070.90 | $51,156.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,656.66 / $25,656.66 / $25,656.66
| Facility | | $25,656.66 | $25,656.66 | $25,656.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,862.54 / $18,273.73 / $30,009.29
| Facility | | $12,862.54 | $18,273.73 | $30,009.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,664.68 / $26,352.04 / $36,157.35
| Facility | | $15,664.68 | $26,352.04 | $36,157.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52,957.60 / $52,957.60 / $62,150.24
| Facility | | $52,957.60 | $52,957.60 | $62,150.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $25,335.08 / $36,188.26
| Facility | | $1,787.00 | $25,335.08 | $36,188.26 |