- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,050.00 / $41,052.50 / $66,727.50
| Facility | | $24,050.00 | $41,052.50 | $66,727.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,728.33 / $35,669.76 / $44,573.11
| Facility | | $12,728.33 | $35,669.76 | $44,573.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,622.75 / $32,618.23 / $51,458.41
| Facility | | $20,622.75 | $32,618.23 | $51,458.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,571.09 / $29,222.35 / $54,499.63
| Facility | | $16,571.09 | $29,222.35 | $54,499.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,842.00 / $34,067.93 / $46,861.13
| Facility | | $6,842.00 | $34,067.93 | $46,861.13 |