- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,481.59 / $33,975.50 / $45,592.50
| Facility | | $20,481.59 | $33,975.50 | $45,592.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,492.33 / $20,492.33 / $27,584.17
| Facility | | $20,492.33 | $20,492.33 | $27,584.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,007.97 / $28,709.46 / $45,936.24
| Facility | | $17,007.97 | $28,709.46 | $45,936.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,818.16 / $27,355.50 / $62,737.10
| Facility | | $16,818.16 | $27,355.50 | $62,737.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,967.68 / $26,846.69 / $38,173.69
| Facility | | $19,967.68 | $26,846.69 | $38,173.69 |