- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $18,620.87 / $18,620.87
| Facility | | $18,620.87 | $18,620.87 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $29,512.09 / $45,708.82
| Facility | | $17,782.79 | $29,512.09 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56,234.13 / $74,131.02 / $77,624.71
| Facility | | $56,234.13 | $74,131.02 | $77,624.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $18,620.87 / $42,657.95
| Facility | | $18,620.87 | $18,620.87 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $30,902.95 / $44,668.36
| Facility | | $19,498.45 | $30,902.95 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $27,542.29 / $30,199.52
| Facility | | $21,877.62 | $27,542.29 | $30,199.52 |