- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $28,840.32 / $53,703.18
| Facility | | $10,964.78 | $28,840.32 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,902.95 / $45,708.82 / $56,234.13
| Facility | | $30,902.95 | $45,708.82 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,547.09 / $38,904.51 / $50,118.72
| Facility | | $24,547.09 | $38,904.51 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $34,673.69 / $87,096.36
| Facility | | $19,054.61 | $34,673.69 | $87,096.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $12,882.50 / $12,882.50
| Facility | | $12,882.50 | $12,882.50 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $30,199.52 / $47,863.01
| Facility | | $8,511.38 | $30,199.52 | $47,863.01 |