- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,572.90 / $28,414.40 / $28,414.40
| Facility | | $25,572.90 | $28,414.40 | $28,414.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,872.07 / $25,872.07 / $36,638.40
| Facility | | $25,872.07 | $25,872.07 | $36,638.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,914.49 / $18,373.31 / $54,183.51
| Facility | | $10,914.49 | $18,373.31 | $54,183.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,607.00 / $31,285.17 / $49,166.83
| Facility | | $17,607.00 | $31,285.17 | $49,166.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $42,450.41 / $54,810.58
| Facility | | $6,965.00 | $42,450.41 | $54,810.58 |