- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $16,982.44 / $45,708.82
| Facility | | $10,964.78 | $16,982.44 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $17,378.01 / $26,915.35
| Facility | | $12,022.64 | $17,378.01 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $22,908.68 / $30,902.95
| Facility | | $14,454.40 | $22,908.68 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66,069.34 / $66,069.34 / $66,069.34
| Facility | | $66,069.34 | $66,069.34 | $66,069.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $23,442.29 / $36,307.81
| Facility | | $2,951.21 | $23,442.29 | $36,307.81 |