- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,574.28 / $14,474.80 / $25,471.50
| Facility | | $8,574.28 | $14,474.80 | $25,471.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,256.00 / $6,586.73 / $13,398.10
| Facility | | $5,256.00 | $6,586.73 | $13,398.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,446.39 / $11,018.00 / $18,050.50
| Facility | | $7,446.39 | $11,018.00 | $18,050.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,799.65 / $13,342.24 / $18,565.47
| Facility | | $7,799.65 | $13,342.24 | $18,565.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,928.35 / $27,928.35 / $32,776.29
| Facility | | $27,928.35 | $27,928.35 | $32,776.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $12,359.20 / $18,018.61
| Facility | | $1,787.00 | $12,359.20 | $18,018.61 |