- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,137.90 / $36,080.80 / $45,974.80
| Facility | | $23,137.90 | $36,080.80 | $45,974.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,424.78 / $31,424.78 / $31,424.78
| Facility | | $31,424.78 | $31,424.78 | $31,424.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,687.57 / $36,960.15 / $43,534.26
| Facility | | $20,687.57 | $36,960.15 | $43,534.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,693.75 / $37,483.44 / $52,511.55
| Facility | | $19,693.75 | $37,483.44 | $52,511.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,618.94 / $40,889.22 / $52,511.55
| Facility | | $35,618.94 | $40,889.22 | $52,511.55 |