- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,690.90 / $40,061.90 / $51,047.60
| Facility | | $25,690.90 | $40,061.90 | $51,047.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,018.50 / $36,018.50 / $36,018.50
| Facility | | $36,018.50 | $36,018.50 | $36,018.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,824.93 / $41,038.25 / $48,337.74
| Facility | | $22,824.93 | $41,038.25 | $48,337.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,866.72 / $41,619.28 / $58,305.57
| Facility | | $21,866.72 | $41,619.28 | $58,305.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,986.85 / $45,400.86 / $58,305.57
| Facility | | $35,986.85 | $45,400.86 | $58,305.57 |