- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,635.80 / $24,293.30 / $31,929.70
| Facility | | $16,635.80 | $24,293.30 | $31,929.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,405.02 / $24,405.02 / $24,405.02
| Facility | | $24,405.02 | $24,405.02 | $24,405.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,534.80 / $17,796.74 / $30,100.78
| Facility | | $6,534.80 | $17,796.74 | $30,100.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,509.99 / $24,513.69 / $44,512.69
| Facility | | $17,509.99 | $24,513.69 | $44,512.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,925.63 / $27,232.10 / $39,761.08
| Facility | | $20,925.63 | $27,232.10 | $39,761.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,925.63 / $25,315.87 / $39,761.08
| Facility | | $20,925.63 | $25,315.87 | $39,761.08 |