- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $19,952.62 / $53,703.18
| Facility | | $12,589.25 | $19,952.62 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $16,218.10 / $25,118.86
| Facility | | $11,220.18 | $16,218.10 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $26,302.68 / $35,481.34
| Facility | | $16,982.44 | $26,302.68 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77,624.71 / $77,624.71 / $77,624.71
| Facility | | $77,624.71 | $77,624.71 | $77,624.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $27,542.29 / $41,686.94
| Facility | | $2,951.21 | $27,542.29 | $41,686.94 |