- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,292.40 / $34,769.40 / $34,769.40
| Facility | | $31,292.40 | $34,769.40 | $34,769.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,853.74 / $25,853.74 / $25,853.74
| Facility | | $25,853.74 | $25,853.74 | $25,853.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,321.00 / $18,288.13 / $35,282.94
| Facility | | $12,321.00 | $18,288.13 | $35,282.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,942.00 / $38,280.21 / $60,163.17
| Facility | | $19,942.00 | $38,280.21 | $60,163.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $51,944.59 / $67,069.17
| Facility | | $6,965.00 | $51,944.59 | $67,069.17 |