- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,702.20 / $23,433.90 / $39,565.90
| Facility | | $10,702.20 | $23,433.90 | $39,565.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,802.75 / $38,289.50 / $49,649.70
| Facility | | $25,802.75 | $38,289.50 | $49,649.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,361.10 / $33,405.47 / $49,037.36
| Facility | | $23,361.10 | $33,405.47 | $49,037.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,190.45 / $33,031.86 / $69,268.85
| Facility | | $17,190.45 | $33,031.86 | $69,268.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,361.10 / $36,370.55 / $49,307.70
| Facility | | $23,361.10 | $36,370.55 | $49,307.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,552.87 / $29,288.72 / $46,242.45
| Facility | | $10,552.87 | $29,288.72 | $46,242.45 |