- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,539.70 / $36,767.40 / $59,762.40
| Facility | | $21,539.70 | $36,767.40 | $59,762.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,707.83 / $13,707.83 / $13,707.83
| Facility | | $13,707.83 | $13,707.83 | $13,707.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,470.13 / $29,213.50 / $46,087.11
| Facility | | $18,470.13 | $29,213.50 | $46,087.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,840.99 / $25,261.91 / $46,533.43
| Facility | | $13,840.99 | $25,261.91 | $46,533.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,842.00 / $30,511.87 / $41,969.70
| Facility | | $6,842.00 | $30,511.87 | $41,969.70 |