- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,801.50 / $27,759.20 / $35,371.40
| Facility | | $17,801.50 | $27,759.20 | $35,371.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,652.25 / $16,652.25 / $24,398.90
| Facility | | $16,652.25 | $16,652.25 | $24,398.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,916.26 / $28,435.80 / $33,493.68
| Facility | | $15,916.26 | $28,435.80 | $33,493.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,151.66 / $28,838.40 / $40,400.48
| Facility | | $15,151.66 | $28,838.40 | $40,400.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,403.92 / $31,458.69 / $40,400.48
| Facility | | $27,403.92 | $31,458.69 | $40,400.48 |