- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,614.40 / $14,542.50 / $25,590.60
| Facility | | $8,614.40 | $14,542.50 | $25,590.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,196.73 / $7,371.85 / $30,346.49
| Facility | | $7,196.73 | $7,371.85 | $30,346.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,702.18 / $8,419.39 / $13,843.46
| Facility | | $5,702.18 | $8,419.39 | $13,843.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,836.14 / $13,404.66 / $18,652.33
| Facility | | $7,836.14 | $13,404.66 | $18,652.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,623.60 / $27,623.60 / $32,418.64
| Facility | | $27,623.60 | $27,623.60 | $32,418.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $12,673.69 / $18,102.91
| Facility | | $1,787.00 | $12,673.69 | $18,102.91 |