- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,115.70 / $29,017.50 / $29,017.50
| Facility | | $26,115.70 | $29,017.50 | $29,017.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,033.33 / $20,223.91 / $43,955.55
| Facility | | $9,033.33 | $20,223.91 | $43,955.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,660.00 / $21,137.11 / $38,815.08
| Facility | | $11,660.00 | $21,137.11 | $38,815.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,109.68 / $31,949.18 / $50,210.37
| Facility | | $18,109.68 | $31,949.18 | $50,210.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $43,351.39 / $55,973.91
| Facility | | $6,965.00 | $43,351.39 | $55,973.91 |