- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,610.90 / $45,801.90 / $61,462.50
| Facility | | $27,610.90 | $45,801.90 | $61,462.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,693.76 / $36,693.76 / $36,693.76
| Facility | | $36,693.76 | $36,693.76 | $36,693.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,646.77 / $38,227.75 / $61,165.87
| Facility | | $22,646.77 | $38,227.75 | $61,165.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,672.29 / $36,877.50 / $84,574.86
| Facility | | $22,672.29 | $36,877.50 | $84,574.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,806.44 / $36,326.80 / $51,461.32
| Facility | | $26,806.44 | $36,326.80 | $51,461.32 |