- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,782.80 / $26,786.20 / $54,436.80
| Facility | | $20,782.80 | $26,786.20 | $54,436.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,500.54 / $25,697.86 / $29,379.30
| Facility | | $20,500.54 | $25,697.86 | $29,379.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,589.14 / $29,364.53 / $38,189.83
| Facility | | $16,589.14 | $29,364.53 | $38,189.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,777.17 / $37,777.17 / $37,777.17
| Facility | | $37,777.17 | $37,777.17 | $37,777.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $26,681.84 / $37,511.19
| Facility | | $1,518.00 | $26,681.84 | $37,511.19 |