- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,299.70 / $33,673.69 / $45,187.50
| Facility | | $20,299.70 | $33,673.69 | $45,187.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,113.41 / $20,113.41 / $20,113.41
| Facility | | $20,113.41 | $20,113.41 | $20,113.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,693.47 / $28,178.58 / $45,086.82
| Facility | | $16,693.47 | $28,178.58 | $45,086.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,250.00 / $27,112.50 / $62,179.81
| Facility | | $17,250.00 | $27,112.50 | $62,179.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,759.66 / $26,707.62 / $38,503.37
| Facility | | $19,759.66 | $26,707.62 | $38,503.37 |