- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,911.90 / $45,738.50 / $61,377.50
| Facility | | $24,911.90 | $45,738.50 | $61,377.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,660.16 / $18,660.16 / $18,660.16
| Facility | | $18,660.16 | $18,660.16 | $18,660.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,662.85 / $28,534.12 / $44,505.13
| Facility | | $13,662.85 | $28,534.12 | $44,505.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,640.93 / $36,826.50 / $84,457.90
| Facility | | $22,640.93 | $36,826.50 | $84,457.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,550.00 / $32,957.26 / $48,856.49
| Facility | | $15,550.00 | $32,957.26 | $48,856.49 |