- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,935.30 / $18,666.09 / $30,340.20
| Facility | | $10,935.30 | $18,666.09 | $30,340.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,697.13 / $19,697.13 / $19,697.13
| Facility | | $19,697.13 | $19,697.13 | $19,697.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,342.00 / $14,831.14 / $23,397.55
| Facility | | $9,342.00 | $14,831.14 | $23,397.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,712.40 / $16,045.92 / $29,836.02
| Facility | | $8,712.40 | $16,045.92 | $29,836.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,289.00 / $15,707.03 / $21,307.22
| Facility | | $6,289.00 | $15,707.03 | $21,307.22 |