- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,487.20 / $43,505.60 / $70,714.89
| Facility | | $25,487.20 | $43,505.60 | $70,714.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,762.25 / $35,762.25 / $35,762.25
| Facility | | $35,762.25 | $35,762.25 | $35,762.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,986.58 / $34,567.33 / $54,533.33
| Facility | | $21,986.58 | $34,567.33 | $54,533.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,596.38 / $42,357.52 / $89,363.11
| Facility | | $20,596.38 | $42,357.52 | $89,363.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,842.00 / $36,103.67 / $49,661.33
| Facility | | $6,842.00 | $36,103.67 | $49,661.33 |