- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,922.30 / $17,691.40 / $17,691.40
| Facility | | $15,922.30 | $17,691.40 | $17,691.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,768.98 / $14,843.14 / $19,058.21
| Facility | | $7,768.98 | $14,843.14 | $19,058.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,706.34 / $12,539.89 / $29,795.15
| Facility | | $7,706.34 | $12,539.89 | $29,795.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,364.00 / $19,961.00 / $30,612.40
| Facility | | $14,364.00 | $19,961.00 | $30,612.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,124.00 / $26,430.60 / $41,511.47
| Facility | | $13,124.00 | $26,430.60 | $41,511.47 |