- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,840.32 / $36,307.81 / $61,659.50
| Facility | | $28,840.32 | $36,307.81 | $61,659.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $28,183.83 / $28,183.83
| Facility | | $28,183.83 | $28,183.83 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $36,307.81 / $54,954.09
| Facility | | $19,054.61 | $36,307.81 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $47,863.01 / $61,659.50
| Facility | | $26,915.35 | $47,863.01 | $61,659.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,118.86 / $47,863.01 / $72,443.60
| Facility | | $25,118.86 | $47,863.01 | $72,443.60 |