- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $14,454.40 / $38,904.51
| Facility | | $9,332.54 | $14,454.40 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $15,488.17 / $24,547.09
| Facility | | $10,715.19 | $15,488.17 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $19,498.45 / $26,302.68
| Facility | | $12,302.69 | $19,498.45 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56,234.13 / $56,234.13 / $56,234.13
| Facility | | $56,234.13 | $56,234.13 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $19,952.62 / $30,902.95
| Facility | | $2,951.21 | $19,952.62 | $30,902.95 |