- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $8,128.31 / $22,387.21
| Facility | | $5,248.07 | $8,128.31 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $12,022.64 / $15,488.17
| Facility | | $2,630.27 | $12,022.64 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $7,244.36 / $11,481.54
| Facility | | $5,128.61 | $7,244.36 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $10,964.78 / $14,791.08
| Facility | | $7,079.46 | $10,964.78 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,359.37 / $32,359.37 / $32,359.37
| Facility | | $32,359.37 | $32,359.37 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $11,481.54 / $17,378.01
| Facility | | $2,951.21 | $11,481.54 | $17,378.01 |