- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,482.10 / $14,798.80 / $30,075.20
| Facility | | $11,482.10 | $14,798.80 | $30,075.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,534.88 / $14,534.88 / $18,000.23
| Facility | | $14,534.88 | $14,534.88 | $18,000.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,340.83 / $14,215.97 / $16,252.53
| Facility | | $11,340.83 | $14,215.97 | $16,252.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,165.16 / $16,223.29 / $21,099.09
| Facility | | $9,165.16 | $16,223.29 | $21,099.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,700.25 / $20,700.25 / $20,700.25
| Facility | | $20,700.25 | $20,700.25 | $20,700.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $14,741.16 / $20,724.15
| Facility | | $1,518.00 | $14,741.16 | $20,724.15 |