- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $31,622.78 / $70,794.58
| Facility | | $21,877.62 | $31,622.78 | $70,794.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58,884.37 / $58,884.37 / $58,884.37
| Facility | | $58,884.37 | $58,884.37 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $7,244.36 / $33,113.11
| Facility | | $3,715.35 | $7,244.36 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $33,884.42 / $52,480.75
| Facility | | $25,703.96 | $33,884.42 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $33,113.11 / $56,234.13
| Facility | | $5,128.61 | $33,113.11 | $56,234.13 |