- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $43,651.58
| Facility | | $43,651.58 | $43,651.58 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $22,387.21 / $36,307.81
| Facility | | $13,489.63 | $22,387.21 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $30,902.95 / $35,481.34
| Facility | | $19,498.45 | $30,902.95 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $26,302.68 / $27,542.29
| Facility | | $13,489.63 | $26,302.68 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $30,902.95 / $42,657.95
| Facility | | $17,782.79 | $30,902.95 | $42,657.95 |