- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $30,199.52 / $43,651.58
| Facility | | $12,882.50 | $30,199.52 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,657.95 / $42,657.95 / $42,657.95
| Facility | | $42,657.95 | $42,657.95 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $38,018.94 / $43,651.58
| Facility | | $28,183.83 | $38,018.94 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,542.29 / $34,673.69 / $47,863.01
| Facility | | $27,542.29 | $34,673.69 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $39,810.72 / $51,286.14
| Facility | | $2,041.74 | $39,810.72 | $51,286.14 |