- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,167.20 / $33,785.50 / $54,844.50
| Facility | | $23,167.20 | $33,785.50 | $54,844.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,196.72 / $59,988.93 / $76,908.89
| Facility | | $42,196.72 | $59,988.93 | $76,908.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,203.74 / $48,019.52 / $63,010.92
| Facility | | $27,203.74 | $48,019.52 | $63,010.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,171.10 / $36,333.90 / $58,099.50
| Facility | | $24,171.10 | $36,333.90 | $58,099.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,267.85 / $48,338.36 / $73,440.02
| Facility | | $28,267.85 | $48,338.36 | $73,440.02 |