- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $20,417.38 / $20,417.38
| Facility | | $20,417.38 | $20,417.38 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $26,915.35 / $45,708.82
| Facility | | $16,982.44 | $26,915.35 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61,659.50 / $81,283.05 / $85,113.80
| Facility | | $61,659.50 | $81,283.05 | $85,113.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $20,417.38 / $46,773.51
| Facility | | $20,417.38 | $20,417.38 | $46,773.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $31,622.78 / $46,773.51
| Facility | | $21,877.62 | $31,622.78 | $46,773.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $30,199.52 / $33,113.11
| Facility | | $23,988.33 | $30,199.52 | $33,113.11 |