- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,895.80 / $22,106.50 / $22,106.50
| Facility | | $19,895.80 | $22,106.50 | $22,106.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,141.00 / $18,064.18 / $22,838.75
| Facility | | $14,141.00 | $18,064.18 | $22,838.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,556.64 / $13,838.37 / $26,118.07
| Facility | | $7,556.64 | $13,838.37 | $26,118.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,927.00 / $24,339.95 / $38,251.93
| Facility | | $11,927.00 | $24,339.95 | $38,251.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $33,026.53 / $42,642.78
| Facility | | $6,965.00 | $33,026.53 | $42,642.78 |