- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,194.80 / $23,694.50 / $30,191.90
| Facility | | $15,194.80 | $23,694.50 | $30,191.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,103.81 / $22,103.81 / $22,103.81
| Facility | | $22,103.81 | $22,103.81 | $22,103.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,080.50 / $24,271.96 / $28,589.22
| Facility | | $12,080.50 | $24,271.96 | $28,589.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,933.01 / $24,615.61 / $34,484.66
| Facility | | $12,933.01 | $24,615.61 | $34,484.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,384.33 / $24,615.61 / $34,484.66
| Facility | | $12,384.33 | $24,615.61 | $34,484.66 |