- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,707.50 / $32,511.20 / $43,627.50
| Facility | | $17,707.50 | $32,511.20 | $43,627.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,766.84 / $26,792.19 / $36,209.32
| Facility | | $19,766.84 | $26,792.19 | $36,209.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,900.00 / $26,466.24 / $44,236.85
| Facility | | $1,900.00 | $26,466.24 | $44,236.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,930.79 / $19,930.79 / $27,254.97
| Facility | | $19,930.79 | $19,930.79 | $27,254.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,107.09 / $25,785.60 / $36,528.43
| Facility | | $19,107.09 | $25,785.60 | $36,528.43 |