- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,482.40 / $47,247.50 / $63,402.50
| Facility | | $28,482.40 | $47,247.50 | $63,402.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,759.19 / $34,012.41 / $38,853.97
| Facility | | $26,759.19 | $34,012.41 | $38,853.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,115.29 / $37,282.72 / $57,648.01
| Facility | | $21,115.29 | $37,282.72 | $57,648.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,387.91 / $39,271.51 / $87,244.38
| Facility | | $23,387.91 | $39,271.51 | $87,244.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,288.55 / $37,333.93 / $53,085.65
| Facility | | $26,288.55 | $37,333.93 | $53,085.65 |