- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,595.70 / $34,456.80 / $45,288.10
| Facility | | $23,595.70 | $34,456.80 | $45,288.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,172.40 / $36,172.40 / $36,172.40
| Facility | | $36,172.40 | $36,172.40 | $36,172.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,724.32 / $21,036.22 / $35,579.94
| Facility | | $7,724.32 | $21,036.22 | $35,579.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,970.04 / $34,609.92 / $57,929.18
| Facility | | $23,970.04 | $34,609.92 | $57,929.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,680.23 / $38,625.12 / $56,395.83
| Facility | | $29,680.23 | $38,625.12 | $56,395.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,680.23 / $35,907.19 / $56,395.83
| Facility | | $29,680.23 | $35,907.19 | $56,395.83 |