- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $28,840.32 / $53,703.18
| Facility | | $18,620.87 | $28,840.32 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $11,220.18 / $11,220.18
| Facility | | $11,220.18 | $11,220.18 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $24,547.09 / $38,904.51
| Facility | | $15,848.93 | $24,547.09 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $16,595.87 / $38,904.51
| Facility | | $6,025.60 | $16,595.87 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $25,703.96 / $36,307.81
| Facility | | $6,918.31 | $25,703.96 | $36,307.81 |