- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,808.80 / $30,064.10 / $52,904.20
| Facility | | $17,808.80 | $30,064.10 | $52,904.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,641.53 / $40,801.60 / $66,899.63
| Facility | | $27,641.53 | $40,801.60 | $66,899.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,199.86 / $27,252.36 / $37,392.66
| Facility | | $16,199.86 | $27,252.36 | $37,392.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,908.56 / $56,593.40 / $66,417.16
| Facility | | $26,908.56 | $56,593.40 | $66,417.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,520.00 / $28,587.37 / $57,561.00
| Facility | | $2,520.00 | $28,587.37 | $57,561.00 |