- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $13,489.63 / $37,153.52
| Facility | | $8,709.64 | $13,489.63 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $15,848.93 / $24,547.09
| Facility | | $10,964.78 | $15,848.93 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $18,197.01 / $24,547.09
| Facility | | $11,748.98 | $18,197.01 | $24,547.09 |
- 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
- $2,951.21 / $18,620.87 / $28,840.32
| Facility | | $2,951.21 | $18,620.87 | $28,840.32 |