- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,933.59 / $31,963.10 / $56,245.80
| Facility | | $18,933.59 | $31,963.10 | $56,245.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,080.77 / $22,260.70 / $36,913.75
| Facility | | $15,080.77 | $22,260.70 | $36,913.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,223.09 / $28,973.69 / $39,754.48
| Facility | | $17,223.09 | $28,973.69 | $39,754.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58,284.10 / $58,284.10 / $68,401.34
| Facility | | $58,284.10 | $58,284.10 | $68,401.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $27,855.55 / $39,788.47
| Facility | | $1,787.00 | $27,855.55 | $39,788.47 |