- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $20,892.96 / $20,892.96
| Facility | | $20,892.96 | $20,892.96 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $29,512.09 / $51,286.14
| Facility | | $17,782.79 | $29,512.09 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61,659.50 / $83,176.38 / $85,113.80
| Facility | | $61,659.50 | $83,176.38 | $85,113.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $20,892.96 / $45,708.82
| Facility | | $20,892.96 | $20,892.96 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $32,359.37 / $52,480.75
| Facility | | $21,877.62 | $32,359.37 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $30,902.95 / $33,113.11
| Facility | | $23,988.33 | $30,902.95 | $33,113.11 |