- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,748.60 / $28,609.60 / $28,609.60
| Facility | | $25,748.60 | $28,609.60 | $28,609.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,814.41 / $20,814.41 / $20,814.41
| Facility | | $20,814.41 | $20,814.41 | $20,814.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,738.39 / $20,698.91 / $48,268.77
| Facility | | $12,738.39 | $20,698.91 | $48,268.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,513.00 / $32,644.00 / $49,504.62
| Facility | | $23,513.00 | $32,644.00 | $49,504.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,067.92 / $36,286.43 / $55,187.15
| Facility | | $14,067.92 | $36,286.43 | $55,187.15 |