- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $29,512.09 / $54,954.09
| Facility | | $21,877.62 | $29,512.09 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,113.11 / $33,113.11 / $33,113.11
| Facility | | $33,113.11 | $33,113.11 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $29,512.09 / $38,018.94
| Facility | | $19,054.61 | $29,512.09 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $31,622.78 / $60,255.96
| Facility | | $20,417.38 | $31,622.78 | $60,255.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $29,512.09 / $39,810.72
| Facility | | $19,054.61 | $29,512.09 | $39,810.72 |