- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,707.50 / $25,707.50 / $30,468.40
| Facility | | $25,707.50 | $25,707.50 | $30,468.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,114.77 / $32,727.80 / $48,958.80
| Facility | | $20,114.77 | $32,727.80 | $48,958.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,025.53 / $26,023.55 / $44,276.05
| Facility | | $21,025.53 | $26,023.55 | $44,276.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,811.18 / $30,182.59 / $49,404.55
| Facility | | $18,811.18 | $30,182.59 | $49,404.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.89 / $18,674.97 / $26,682.04
| Facility | | $295.89 | $18,674.97 | $26,682.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,406.21 / $29,819.12 / $35,044.94
| Facility | | $21,406.21 | $29,819.12 | $35,044.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,319.09 / $31,806.44 / $40,094.61
| Facility | | $19,319.09 | $31,806.44 | $40,094.61 |