- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $38,904.51 / $51,286.14
| Facility | | $23,988.33 | $38,904.51 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,113.11 / $33,113.11 / $33,113.11
| Facility | | $33,113.11 | $33,113.11 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,113.11 / $48,977.88 / $60,255.96
| Facility | | $33,113.11 | $48,977.88 | $60,255.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,773.51 / $46,773.51 / $46,773.51
| Facility | | $46,773.51 | $46,773.51 | $46,773.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,547.09 / $36,307.81 / $48,977.88
| Facility | | $24,547.09 | $36,307.81 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,773.51 / $46,773.51 / $46,773.51
| Facility | | $46,773.51 | $46,773.51 | $46,773.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $32,359.37 / $53,703.18
| Facility | | $21,379.62 | $32,359.37 | $53,703.18 |