- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,376.50 / $19,307.20 / $19,307.20
| Facility | | $17,376.50 | $19,307.20 | $19,307.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,023.23 / $14,577.33 / $17,726.78
| Facility | | $9,023.23 | $14,577.33 | $17,726.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,649.05 / $13,018.09 / $30,172.85
| Facility | | $7,649.05 | $13,018.09 | $30,172.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,536.00 / $21,257.87 / $33,408.23
| Facility | | $14,536.00 | $21,257.87 | $33,408.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $28,844.51 / $37,243.08
| Facility | | $6,965.00 | $28,844.51 | $37,243.08 |