- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,556.80 / $28,261.80 / $45,937.20
| Facility | | $16,556.80 | $28,261.80 | $45,937.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,578.63 / $18,578.63 / $18,578.63
| Facility | | $18,578.63 | $18,578.63 | $18,578.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,197.32 / $22,455.36 / $35,425.50
| Facility | | $14,197.32 | $22,455.36 | $35,425.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,408.03 / $22,297.41 / $42,473.99
| Facility | | $11,408.03 | $22,297.41 | $42,473.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,551.34 / $25,553.82 / $33,616.60
| Facility | | $16,551.34 | $25,553.82 | $33,616.60 |