- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,545.70 / $34,684.50 / $61,034.70
| Facility | | $20,545.70 | $34,684.50 | $61,034.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,332.10 / $23,400.66 / $38,364.71
| Facility | | $16,332.10 | $23,400.66 | $38,364.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,689.52 / $31,440.60 / $43,139.30
| Facility | | $18,689.52 | $31,440.60 | $43,139.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64,879.95 / $64,879.95 / $76,142.13
| Facility | | $64,879.95 | $64,879.95 | $76,142.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $30,227.26 / $43,176.18
| Facility | | $1,787.00 | $30,227.26 | $43,176.18 |