- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,074.90 / $17,692.12 / $27,398.10
| Facility | | $12,074.90 | $17,692.12 | $27,398.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,256.45 / $34,484.17 / $44,210.48
| Facility | | $24,256.45 | $34,484.17 | $44,210.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,116.52 / $26,665.75 / $594,737.48
| Facility | | $13,116.52 | $26,665.75 | $594,737.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,074.90 / $18,150.90 / $29,024.20
| Facility | | $12,074.90 | $18,150.90 | $29,024.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,121.48 / $24,147.90 / $36,687.68
| Facility | | $14,121.48 | $24,147.90 | $36,687.68 |