- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,738.80 / $30,284.80 / $39,804.60
| Facility | | $20,738.80 | $30,284.80 | $39,804.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,190.55 / $22,305.96 / $37,727.51
| Facility | | $8,190.55 | $22,305.96 | $37,727.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,828.52 / $30,559.55 / $54,509.61
| Facility | | $21,828.52 | $30,559.55 | $54,509.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,086.56 / $33,948.41 / $49,567.45
| Facility | | $26,086.56 | $33,948.41 | $49,567.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,086.56 / $31,559.57 / $49,567.45
| Facility | | $26,086.56 | $31,559.57 | $49,567.45 |