- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,584.40 / $28,980.20 / $36,927.10
| Facility | | $18,584.40 | $28,980.20 | $36,927.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,151.40 / $27,151.40 / $27,151.40
| Facility | | $27,151.40 | $27,151.40 | $27,151.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,313.82 / $29,686.46 / $34,966.80
| Facility | | $16,313.82 | $29,686.46 | $34,966.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,818.06 / $30,106.77 / $42,177.38
| Facility | | $15,818.06 | $30,106.77 | $42,177.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,146.98 / $29,969.02 / $40,466.12
| Facility | | $15,146.98 | $29,969.02 | $40,466.12 |