- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,412.70 / $39,964.50 / $64,959.10
| Facility | | $23,412.70 | $39,964.50 | $64,959.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,076.50 / $23,076.50 / $23,076.50
| Facility | | $23,076.50 | $23,076.50 | $23,076.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,001.43 / $31,753.80 / $50,094.69
| Facility | | $20,001.43 | $31,753.80 | $50,094.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,505.93 / $27,579.40 / $50,579.82
| Facility | | $14,505.93 | $27,579.40 | $50,579.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,842.00 / $33,165.08 / $45,619.24
| Facility | | $6,842.00 | $33,165.08 | $45,619.24 |