- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $12,882.50 / $35,481.34
| Facility | | $8,317.64 | $12,882.50 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $10,471.29 / $16,595.87
| Facility | | $7,244.36 | $10,471.29 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $20,417.38 / $23,442.29
| Facility | | $12,302.69 | $20,417.38 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51,286.14 / $51,286.14 / $51,286.14
| Facility | | $51,286.14 | $51,286.14 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $17,782.79 / $27,542.29
| Facility | | $2,951.21 | $17,782.79 | $27,542.29 |