- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,452.20 / $47,169.10 / $47,169.10
| Facility | | $42,452.20 | $47,169.10 | $47,169.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,715.20 / $27,715.20 / $27,715.20
| Facility | | $27,715.20 | $27,715.20 | $27,715.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,737.22 / $20,660.66 / $64,398.48
| Facility | | $12,737.22 | $20,660.66 | $64,398.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,942.00 / $51,934.68 / $81,618.99
| Facility | | $19,942.00 | $51,934.68 | $81,618.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $59,612.17 / $90,987.86
| Facility | | $6,965.00 | $59,612.17 | $90,987.86 |