- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $26,302.68 / $30,199.52
| Facility | | $20,417.38 | $26,302.68 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,547.09 / $24,547.09 / $24,547.09
| Facility | | $24,547.09 | $24,547.09 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $24,547.09 / $30,199.52
| Facility | | $20,892.96 | $24,547.09 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $30,199.52 / $38,018.94
| Facility | | $18,620.87 | $30,199.52 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,840.32 / $28,840.32 / $28,840.32
| Facility | | $28,840.32 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $29,512.09 / $38,904.51
| Facility | | $1,862.09 | $29,512.09 | $38,904.51 |