- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,403.80 / $16,004.20 / $16,004.20
| Facility | | $14,403.80 | $16,004.20 | $16,004.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,938.67 / $17,469.99 / $24,854.33
| Facility | | $14,938.67 | $17,469.99 | $24,854.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,584.17 / $10,418.96 / $20,084.31
| Facility | | $6,584.17 | $10,418.96 | $20,084.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,806.64 / $17,621.18 / $27,692.91
| Facility | | $11,806.64 | $17,621.18 | $27,692.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $23,909.93 / $30,871.72
| Facility | | $6,965.00 | $23,909.93 | $30,871.72 |