- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,687.81 / $28,183.20 / $45,117.10
| Facility | | $18,687.81 | $28,183.20 | $45,117.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,682.81 / $28,682.81 / $28,682.81
| Facility | | $28,682.81 | $28,682.81 | $28,682.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,403.15 / $22,182.90 / $31,480.06
| Facility | | $11,403.15 | $22,182.90 | $31,480.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,781.75 / $22,482.62 / $39,392.54
| Facility | | $16,781.75 | $22,482.62 | $39,392.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,478.33 / $25,461.79 / $34,119.56
| Facility | | $16,478.33 | $25,461.79 | $34,119.56 |