- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $13,803.84 / $37,153.52
| Facility | | $12,589.25 | $13,803.84 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $23,988.33 / $36,307.81
| Facility | | $16,595.87 | $23,988.33 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $18,620.87 / $26,915.35
| Facility | | $12,589.25 | $18,620.87 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53,703.18 / $53,703.18 / $53,703.18
| Facility | | $53,703.18 | $53,703.18 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $20,892.96 / $39,810.72
| Facility | | $3,890.45 | $20,892.96 | $39,810.72 |