- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $33,884.42 / $44,668.36
| Facility | | $20,892.96 | $33,884.42 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41,686.94 / $61,659.50 / $75,857.76
| Facility | | $41,686.94 | $61,659.50 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,738.03 / $40,738.03 / $40,738.03
| Facility | | $40,738.03 | $40,738.03 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $30,902.95 / $42,657.95
| Facility | | $21,877.62 | $30,902.95 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,738.03 / $40,738.03 / $40,738.03
| Facility | | $40,738.03 | $40,738.03 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $29,512.09 / $46,773.51
| Facility | | $19,054.61 | $29,512.09 | $46,773.51 |