- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,094.90 / $17,883.20 / $17,883.20
| Facility | | $16,094.90 | $17,883.20 | $17,883.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,233.14 / $10,233.14 / $10,233.14
| Facility | | $10,233.14 | $10,233.14 | $10,233.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,642.02 / $15,987.33 / $31,674.12
| Facility | | $9,642.02 | $15,987.33 | $31,674.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,364.00 / $20,177.00 / $30,944.16
| Facility | | $14,364.00 | $20,177.00 | $30,944.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $26,717.04 / $34,496.17
| Facility | | $6,965.00 | $26,717.04 | $34,496.17 |