- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,512.09 / $37,153.52 / $63,095.73
| Facility | | $29,512.09 | $37,153.52 | $63,095.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,673.69 / $34,673.69 / $34,673.69
| Facility | | $34,673.69 | $34,673.69 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $34,673.69 / $56,234.13
| Facility | | $14,125.38 | $34,673.69 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $48,977.88 / $63,095.73
| Facility | | $20,417.38 | $48,977.88 | $63,095.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $45,708.82 / $70,794.58
| Facility | | $25,703.96 | $45,708.82 | $70,794.58 |