- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,938.50 / $30,576.40 / $40,187.90
| Facility | | $20,938.50 | $30,576.40 | $40,187.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,505.70 / $23,505.70 / $23,505.70
| Facility | | $23,505.70 | $23,505.70 | $23,505.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,637.06 / $18,075.21 / $30,571.78
| Facility | | $6,637.06 | $18,075.21 | $30,571.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,270.63 / $30,712.29 / $51,405.44
| Facility | | $21,270.63 | $30,712.29 | $51,405.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,337.76 / $34,275.33 / $50,044.77
| Facility | | $26,337.76 | $34,275.33 | $50,044.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,337.76 / $31,863.48 / $50,044.77
| Facility | | $26,337.76 | $31,863.48 | $50,044.77 |