- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,330.82 / $9,448.43 / $19,201.70
| Facility | | $7,330.82 | $9,448.43 | $19,201.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,849.77 / $10,661.75 / $11,142.74
| Facility | | $6,849.77 | $10,661.75 | $11,142.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,285.31 / $9,132.29 / $10,440.57
| Facility | | $7,285.31 | $9,132.29 | $10,440.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,851.56 / $10,357.87 / $13,470.86
| Facility | | $5,851.56 | $10,357.87 | $13,470.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,006.16 / $13,006.16 / $13,006.16
| Facility | | $13,006.16 | $13,006.16 | $13,006.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $8,306.76 / $12,792.62
| Facility | | $1,286.00 | $8,306.76 | $12,792.62 |