- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,234.30 / $29,452.40 / $51,530.60
| Facility | | $22,234.30 | $29,452.40 | $51,530.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,080.37 / $22,080.37 / $22,080.37
| Facility | | $22,080.37 | $22,080.37 | $22,080.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $24,777.60 / $48,388.49
| Facility | | $5,939.30 | $24,777.60 | $48,388.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,767.28 / $28,257.14 / $46,007.78
| Facility | | $16,767.28 | $28,257.14 | $46,007.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $30,352.12 / $52,136.57
| Facility | | $3,496.00 | $30,352.12 | $52,136.57 |