- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,028.10 / $33,364.50 / $33,364.50
| Facility | | $30,028.10 | $33,364.50 | $33,364.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,371.96 / $21,371.96 / $25,433.10
| Facility | | $21,371.96 | $21,371.96 | $25,433.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,397.93 / $29,571.80 / $53,620.64
| Facility | | $19,397.93 | $29,571.80 | $53,620.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,579.79 / $39,097.54 / $57,732.27
| Facility | | $27,579.79 | $39,097.54 | $57,732.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,599.97 / $49,845.77 / $64,359.23
| Facility | | $27,599.97 | $49,845.77 | $64,359.23 |