- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,170.20 / $17,966.80 / $17,966.80
| Facility | | $16,170.20 | $17,966.80 | $17,966.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,924.53 / $13,830.59 / $27,700.40
| Facility | | $7,924.53 | $13,830.59 | $27,700.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,354.90 / $11,705.26 / $20,726.72
| Facility | | $7,354.90 | $11,705.26 | $20,726.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,364.00 / $20,241.00 / $31,088.93
| Facility | | $14,364.00 | $20,241.00 | $31,088.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $26,842.03 / $34,657.56
| Facility | | $6,965.00 | $26,842.03 | $34,657.56 |