- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,815.80 / $36,188.80 / $48,562.50
| Facility | | $21,815.80 | $36,188.80 | $48,562.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,944.94 / $25,628.84 / $30,492.92
| Facility | | $15,944.94 | $25,628.84 | $30,492.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,209.53 / $30,636.22 / $49,019.14
| Facility | | $17,209.53 | $30,636.22 | $49,019.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,913.74 / $29,137.50 / $66,823.94
| Facility | | $17,913.74 | $29,137.50 | $66,823.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,268.43 / $28,702.38 / $40,660.41
| Facility | | $21,268.43 | $28,702.38 | $40,660.41 |