- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,685.60 / $40,761.80 / $40,761.80
| Facility | | $36,685.60 | $40,761.80 | $40,761.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,411.91 / $42,411.91 / $42,411.91
| Facility | | $42,411.91 | $42,411.91 | $42,411.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,019.32 / $30,086.17 / $53,935.64
| Facility | | $18,019.32 | $30,086.17 | $53,935.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,439.29 / $46,016.63 / $70,532.17
| Facility | | $25,439.29 | $46,016.63 | $70,532.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,377.42 / $60,897.14 / $78,628.41
| Facility | | $34,377.42 | $60,897.14 | $78,628.41 |