- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,321.40 / $33,924.80 / $68,944.10
| Facility | | $26,321.40 | $33,924.80 | $68,944.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,074.58 / $29,074.58 / $29,074.58
| Facility | | $29,074.58 | $29,074.58 | $29,074.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,119.02 / $28,980.18 / $33,131.83
| Facility | | $23,119.02 | $28,980.18 | $33,131.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,010.13 / $37,190.14 / $48,367.38
| Facility | | $21,010.13 | $37,190.14 | $48,367.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,435.76 / $33,435.76 / $33,435.76
| Facility | | $33,435.76 | $33,435.76 | $33,435.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $33,792.51 / $47,507.88
| Facility | | $1,518.00 | $33,792.51 | $47,507.88 |