- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,085.50 / $38,092.50 / $50,066.70
| Facility | | $26,085.50 | $38,092.50 | $50,066.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,835.00 / $18,614.27 / $31,483.53
| Facility | | $6,835.00 | $18,614.27 | $31,483.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,456.15 / $38,438.12 / $68,562.78
| Facility | | $27,456.15 | $38,438.12 | $68,562.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,811.94 / $42,700.68 / $62,346.47
| Facility | | $32,811.94 | $42,700.68 | $62,346.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,811.94 / $39,695.97 / $62,346.47
| Facility | | $32,811.94 | $39,695.97 | $62,346.47 |