- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,118.86 / $33,113.11 / $53,703.18
| Facility | | $25,118.86 | $33,113.11 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52,480.75 / $52,480.75 / $52,480.75
| Facility | | $52,480.75 | $52,480.75 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $31,622.78 / $47,863.01
| Facility | | $18,197.01 | $31,622.78 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $41,686.94 / $53,703.18
| Facility | | $26,915.35 | $41,686.94 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $41,686.94 / $64,565.42
| Facility | | $21,877.62 | $41,686.94 | $64,565.42 |