- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,280.90 / $26,957.80 / $44,756.40
| Facility | | $18,280.90 | $26,957.80 | $44,756.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,500.34 / $32,500.34 / $32,500.34
| Facility | | $32,500.34 | $32,500.34 | $32,500.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,413.09 / $24,587.79 / $41,652.23
| Facility | | $16,413.09 | $24,587.79 | $41,652.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,236.80 / $29,467.80 / $44,243.00
| Facility | | $23,236.80 | $29,467.80 | $44,243.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,892.62 / $27,621.15 / $73,392.89
| Facility | | $13,892.62 | $27,621.15 | $73,392.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,892.62 / $27,274.47 / $38,735.71
| Facility | | $13,892.62 | $27,274.47 | $38,735.71 |