- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $18,197.01 / $50,118.72
| Facility | | $11,748.98 | $18,197.01 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $19,952.62 / $30,902.95
| Facility | | $13,803.84 | $19,952.62 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $24,547.09 / $33,113.11
| Facility | | $15,135.61 | $24,547.09 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72,443.60 / $72,443.60 / $72,443.60
| Facility | | $72,443.60 | $72,443.60 | $72,443.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $22,387.21 / $37,153.52
| Facility | | $3,801.89 | $22,387.21 | $37,153.52 |