- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $15,135.61 / $41,686.94
| Facility | | $9,772.37 | $15,135.61 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $16,982.44 / $26,302.68
| Facility | | $11,748.98 | $16,982.44 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $20,417.38 / $27,542.29
| Facility | | $13,182.57 | $20,417.38 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60,255.96 / $60,255.96 / $60,255.96
| Facility | | $60,255.96 | $60,255.96 | $60,255.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $21,379.62 / $32,359.37
| Facility | | $2,951.21 | $21,379.62 | $32,359.37 |