- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,232.40 / $39,671.50 / $69,786.60
| Facility | | $21,232.40 | $39,671.50 | $69,786.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,094.33 / $36,094.33 / $36,899.51
| Facility | | $36,094.33 | $36,094.33 | $36,899.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,356.02 / $34,113.60 / $53,817.50
| Facility | | $21,356.02 | $34,113.60 | $53,817.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,217.50 / $27,362.98 / $54,276.88
| Facility | | $13,217.50 | $27,362.98 | $54,276.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,842.00 / $35,629.76 / $49,009.46
| Facility | | $6,842.00 | $35,629.76 | $49,009.46 |