- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,375.60 / $31,172.80 / $50,603.20
| Facility | | $21,375.60 | $31,172.80 | $50,603.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,841.52 / $62,327.27 / $79,906.75
| Facility | | $43,841.52 | $62,327.27 | $79,906.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,099.98 / $46,752.00 / $58,138.07
| Facility | | $25,099.98 | $46,752.00 | $58,138.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,301.90 / $33,524.10 / $53,606.40
| Facility | | $22,301.90 | $33,524.10 | $53,606.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,081.79 / $42,590.88 / $66,980.44
| Facility | | $26,081.79 | $42,590.88 | $66,980.44 |