- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,974.40 / $31,475.40 / $42,237.50
| Facility | | $18,974.40 | $31,475.40 | $42,237.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,197.47 / $22,197.47 / $22,197.47
| Facility | | $22,197.47 | $22,197.47 | $22,197.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,926.38 / $26,142.52 / $41,829.03
| Facility | | $14,926.38 | $26,142.52 | $41,829.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,580.57 / $25,342.50 / $58,120.49
| Facility | | $15,580.57 | $25,342.50 | $58,120.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,388.52 / $24,964.05 / $35,364.61
| Facility | | $18,388.52 | $24,964.05 | $35,364.61 |