- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $20,417.38 / $54,954.09
| Facility | | $12,882.50 | $20,417.38 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $25,703.96 / $39,810.72
| Facility | | $17,782.79 | $25,703.96 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $26,915.35 / $36,307.81
| Facility | | $17,378.01 | $26,915.35 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79,432.82 / $79,432.82 / $79,432.82
| Facility | | $79,432.82 | $79,432.82 | $79,432.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $28,183.83 / $42,657.95
| Facility | | $2,951.21 | $28,183.83 | $42,657.95 |