- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $28,183.83 / $37,153.52
| Facility | | $17,378.01 | $28,183.83 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $18,197.01 / $18,197.01
| Facility | | $18,197.01 | $18,197.01 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $41,686.94 / $51,286.14
| Facility | | $28,183.83 | $41,686.94 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,113.11 / $33,113.11 / $33,113.11
| Facility | | $33,113.11 | $33,113.11 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $26,302.68 / $34,673.69
| Facility | | $17,782.79 | $26,302.68 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,113.11 / $33,113.11 / $33,113.11
| Facility | | $33,113.11 | $33,113.11 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $23,988.33 / $38,904.51
| Facility | | $15,488.17 | $23,988.33 | $38,904.51 |