- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,183.13 / $14,137.70 / $22,763.60
| Facility | | $6,183.13 | $14,137.70 | $22,763.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,549.13 / $5,549.13 / $17,896.08
| Facility | | $5,549.13 | $5,549.13 | $17,896.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $7,285.94 / $19,361.49
| Facility | | $1,474.01 | $7,285.94 | $19,361.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,233.90 / $14,781.91 / $20,940.36
| Facility | | $10,233.90 | $14,781.91 | $20,940.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,593.00 / $12,398.00 / $26,037.33
| Facility | | $8,593.00 | $12,398.00 | $26,037.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,593.00 / $15,126.33 / $22,352.13
| Facility | | $8,593.00 | $15,126.33 | $22,352.13 |