- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,314.70 / $32,606.40 / $57,377.80
| Facility | | $19,314.70 | $32,606.40 | $57,377.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,247.29 / $28,247.29 / $28,247.29
| Facility | | $28,247.29 | $28,247.29 | $28,247.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,319.46 / $33,213.37 / $54,185.97
| Facility | | $22,319.46 | $33,213.37 | $54,185.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,569.74 / $29,556.85 / $40,554.62
| Facility | | $17,569.74 | $29,556.85 | $40,554.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62,537.35 / $62,537.35 / $73,392.89
| Facility | | $62,537.35 | $62,537.35 | $73,392.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $28,416.20 / $40,589.29
| Facility | | $1,787.00 | $28,416.20 | $40,589.29 |