- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,645.80 / $21,348.20 / $37,566.69
| Facility | | $12,645.80 | $21,348.20 | $37,566.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,414.59 / $8,947.92 / $14,659.15
| Facility | | $6,414.59 | $8,947.92 | $14,659.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,503.35 / $19,509.06 / $27,171.58
| Facility | | $11,503.35 | $19,509.06 | $27,171.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,672.95 / $42,672.95 / $50,080.33
| Facility | | $42,672.95 | $42,672.95 | $50,080.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $18,604.79 / $26,574.82
| Facility | | $1,787.00 | $18,604.79 | $26,574.82 |