- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,280.60 / $32,744.60 / $50,554.90
| Facility | | $22,280.60 | $32,744.60 | $50,554.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,109.49 / $39,961.83 / $51,233.13
| Facility | | $28,109.49 | $39,961.83 | $51,233.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,076.02 / $46,707.38 / $58,082.58
| Facility | | $25,076.02 | $46,707.38 | $58,082.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,280.60 / $33,492.10 / $53,555.30
| Facility | | $22,280.60 | $33,492.10 | $53,555.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,056.90 / $44,557.62 / $67,695.98
| Facility | | $26,056.90 | $44,557.62 | $67,695.98 |