- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $34,673.69 / $79,432.82
| Facility | | $23,988.33 | $34,673.69 | $79,432.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53,703.18 / $53,703.18 / $53,703.18
| Facility | | $53,703.18 | $53,703.18 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $28,183.83 / $53,703.18
| Facility | | $16,595.87 | $28,183.83 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $35,481.34 / $48,977.88
| Facility | | $18,197.01 | $35,481.34 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,512.09 / $53,703.18 / $81,283.05
| Facility | | $29,512.09 | $53,703.18 | $81,283.05 |