- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,551.50 / $25,898.60 / $45,312.70
| Facility | | $19,551.50 | $25,898.60 | $45,312.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,184.31 / $10,184.31 / $10,184.31
| Facility | | $10,184.31 | $10,184.31 | $10,184.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,707.53 / $19,672.83 / $43,992.75
| Facility | | $5,707.53 | $19,672.83 | $43,992.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,744.09 / $24,847.55 / $40,456.35
| Facility | | $14,744.09 | $24,847.55 | $40,456.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $26,689.75 / $40,765.29
| Facility | | $3,496.00 | $26,689.75 | $40,765.29 |