- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,719.80 / $31,910.80 / $31,910.80
| Facility | | $28,719.80 | $31,910.80 | $31,910.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,580.50 / $14,141.00 / $26,750.76
| Facility | | $13,580.50 | $14,141.00 | $26,750.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,036.82 / $17,165.84 / $40,045.30
| Facility | | $9,036.82 | $17,165.84 | $40,045.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,915.43 / $35,134.87 / $55,216.93
| Facility | | $19,915.43 | $35,134.87 | $55,216.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $47,674.03 / $61,555.16
| Facility | | $6,965.00 | $47,674.03 | $61,555.16 |