- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,522.90 / $39,020.50 / $52,362.50
| Facility | | $23,522.90 | $39,020.50 | $52,362.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,296.61 / $24,212.81 / $40,182.85
| Facility | | $21,296.61 | $24,212.81 | $40,182.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,497.73 / $32,219.04 / $49,818.34
| Facility | | $18,497.73 | $32,219.04 | $49,818.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,315.48 / $32,433.33 / $72,052.89
| Facility | | $19,315.48 | $32,433.33 | $72,052.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,796.54 / $30,833.13 / $43,842.07
| Facility | | $22,796.54 | $30,833.13 | $43,842.07 |