- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $14,454.40 / $39,810.72
| Facility | | $12,589.25 | $14,454.40 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $20,417.38 / $30,902.95
| Facility | | $14,125.38 | $20,417.38 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $19,498.45 / $26,302.68
| Facility | | $12,589.25 | $19,498.45 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57,543.99 / $57,543.99 / $57,543.99
| Facility | | $57,543.99 | $57,543.99 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $20,417.38 / $30,902.95
| Facility | | $2,951.21 | $20,417.38 | $30,902.95 |