- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,422.40 / $30,469.40 / $30,469.40
| Facility | | $27,422.40 | $30,469.40 | $30,469.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,717.79 / $25,717.79 / $46,727.68
| Facility | | $25,717.79 | $25,717.79 | $46,727.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,048.04 / $23,676.35 / $42,257.02
| Facility | | $13,048.04 | $23,676.35 | $42,257.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,015.83 / $34,397.36 / $52,722.70
| Facility | | $19,015.83 | $34,397.36 | $52,722.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,982.41 / $38,645.25 / $58,774.62
| Facility | | $14,982.41 | $38,645.25 | $58,774.62 |