- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,998.80 / $34,137.10 / $55,487.10
| Facility | | $19,998.80 | $34,137.10 | $55,487.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,168.90 / $21,168.90 / $25,893.53
| Facility | | $21,168.90 | $21,168.90 | $25,893.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,148.81 / $27,123.62 / $42,790.14
| Facility | | $17,148.81 | $27,123.62 | $42,790.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,369.20 / $30,810.47 / $59,406.56
| Facility | | $16,369.20 | $30,810.47 | $59,406.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,874.28 / $30,866.23 / $41,090.00
| Facility | | $19,874.28 | $30,866.23 | $41,090.00 |