- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,025.60 / $37,596.90 / $61,110.70
| Facility | | $22,025.60 | $37,596.90 | $61,110.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,324.81 / $32,324.81 / $33,326.93
| Facility | | $32,324.81 | $32,324.81 | $33,326.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,816.48 / $29,872.58 / $47,126.89
| Facility | | $18,816.48 | $29,872.58 | $47,126.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,835.80 / $29,423.41 / $54,486.80
| Facility | | $16,835.80 | $29,423.41 | $54,486.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,000.00 / $31,636.80 / $43,300.82
| Facility | | $18,000.00 | $31,636.80 | $43,300.82 |