- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,821.50 / $27,579.50 / $27,579.50
| Facility | | $24,821.50 | $27,579.50 | $27,579.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,984.20 / $29,984.20 / $29,984.20
| Facility | | $29,984.20 | $29,984.20 | $29,984.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,503.49 / $14,984.51 / $40,023.22
| Facility | | $8,503.49 | $14,984.51 | $40,023.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,098.00 / $30,365.92 / $47,722.17
| Facility | | $13,098.00 | $30,365.92 | $47,722.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $34,979.91 / $53,200.09
| Facility | | $6,965.00 | $34,979.91 | $53,200.09 |