- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,442.29 / $52,480.75 / $117,489.76
| Facility | | $23,442.29 | $52,480.75 | $117,489.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,542.29 / $27,542.29 / $27,542.29
| Facility | | $27,542.29 | $27,542.29 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $29,512.09 / $51,286.14
| Facility | | $19,952.62 | $29,512.09 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,542.29 / $43,651.58 / $63,095.73
| Facility | | $27,542.29 | $43,651.58 | $63,095.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,542.29 / $50,118.72 / $79,432.82
| Facility | | $27,542.29 | $50,118.72 | $79,432.82 |