- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,468.20 / $42,758.60 / $59,166.80
| Facility | | $26,468.20 | $42,758.60 | $59,166.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,266.56 / $24,266.56 / $24,266.56
| Facility | | $24,266.56 | $24,266.56 | $24,266.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,346.79 / $37,409.92 / $56,676.83
| Facility | | $23,346.79 | $37,409.92 | $56,676.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,539.51 / $39,536.12 / $61,241.59
| Facility | | $25,539.51 | $39,536.12 | $61,241.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,244.20 / $37,995.87 / $57,955.72
| Facility | | $23,244.20 | $37,995.87 | $57,955.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,403.00 / $46,035.38 / $65,765.70
| Facility | | $10,403.00 | $46,035.38 | $65,765.70 |