- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,690.10 / $17,433.50 / $17,433.50
| Facility | | $15,690.10 | $17,433.50 | $17,433.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,015.47 / $13,015.47 / $14,371.56
| Facility | | $13,015.47 | $13,015.47 | $14,371.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,031.31 / $11,331.27 / $27,978.41
| Facility | | $7,031.31 | $11,331.27 | $27,978.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,364.00 / $19,680.93 / $30,166.03
| Facility | | $14,364.00 | $19,680.93 | $30,166.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $26,045.21 / $33,628.72
| Facility | | $6,965.00 | $26,045.21 | $33,628.72 |