- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,267.40 / $38,009.60 / $61,781.50
| Facility | | $22,267.40 | $38,009.60 | $61,781.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,638.16 / $30,638.16 / $30,638.16
| Facility | | $30,638.16 | $30,638.16 | $30,638.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,094.14 / $30,200.47 / $47,644.16
| Facility | | $19,094.14 | $30,200.47 | $47,644.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,205.06 / $36,683.73 / $72,081.66
| Facility | | $18,205.06 | $36,683.73 | $72,081.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,346.40 / $34,612.00 / $45,751.16
| Facility | | $24,346.40 | $34,612.00 | $45,751.16 |