- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,061.10 / $18,122.90 / $36,830.50
| Facility | | $14,061.10 | $18,122.90 | $36,830.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,068.31 / $20,068.31 / $20,068.31
| Facility | | $20,068.31 | $20,068.31 | $20,068.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,834.35 / $17,341.65 / $19,825.99
| Facility | | $13,834.35 | $17,341.65 | $19,825.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,223.78 / $19,867.28 / $25,838.25
| Facility | | $11,223.78 | $19,867.28 | $25,838.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $15,933.06 / $24,537.31
| Facility | | $1,286.00 | $15,933.06 | $24,537.31 |