- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,925.80 / $45,106.30 / $57,475.30
| Facility | | $28,925.80 | $45,106.30 | $57,475.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,761.56 / $36,761.56 / $36,761.56
| Facility | | $36,761.56 | $36,761.56 | $36,761.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,445.35 / $46,205.65 / $54,424.26
| Facility | | $23,445.35 | $46,205.65 | $54,424.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,620.11 / $46,859.84 / $65,647.20
| Facility | | $24,620.11 | $46,859.84 | $65,647.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,575.60 / $46,645.44 / $62,983.71
| Facility | | $23,575.60 | $46,645.44 | $62,983.71 |