- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,047.80 / $17,830.90 / $17,830.90
| Facility | | $16,047.80 | $17,830.90 | $17,830.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,263.54 / $11,869.92 / $16,674.53
| Facility | | $6,263.54 | $11,869.92 | $16,674.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,255.46 / $15,306.20 / $26,436.61
| Facility | | $8,255.46 | $15,306.20 | $26,436.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,364.00 / $20,118.00 / $30,853.68
| Facility | | $14,364.00 | $20,118.00 | $30,853.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $26,638.92 / $34,395.31
| Facility | | $6,965.00 | $26,638.92 | $34,395.31 |