- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $29,512.09 / $54,954.09
| Facility | | $18,620.87 | $29,512.09 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $13,489.63 / $13,489.63
| Facility | | $13,489.63 | $13,489.63 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $24,547.09 / $39,810.72
| Facility | | $16,218.10 | $24,547.09 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $36,307.81 / $87,096.36
| Facility | | $16,218.10 | $36,307.81 | $87,096.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $28,183.83 / $38,018.94
| Facility | | $15,848.93 | $28,183.83 | $38,018.94 |