- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,590.90 / $25,950.90 / $45,404.20
| Facility | | $19,590.90 | $25,950.90 | $45,404.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,597.38 / $21,597.38 / $21,597.38
| Facility | | $21,597.38 | $21,597.38 | $21,597.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $22,843.10 / $45,088.29
| Facility | | $5,939.30 | $22,843.10 | $45,088.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,846.68 / $24,897.72 / $40,538.03
| Facility | | $15,846.68 | $24,897.72 | $40,538.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $26,743.63 / $45,938.18
| Facility | | $3,496.00 | $26,743.63 | $45,938.18 |