- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,725.40 / $9,807.87 / $15,921.30
| Facility | | $6,725.40 | $9,807.87 | $15,921.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,777.32 / $14,777.32 / $14,777.32
| Facility | | $14,777.32 | $14,777.32 | $14,777.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,686.17 / $19,456.93 / $24,944.78
| Facility | | $13,686.17 | $19,456.93 | $24,944.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,897.20 / $15,268.50 / $19,311.89
| Facility | | $7,897.20 | $15,268.50 | $19,311.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,016.83 / $10,547.70 / $16,866.20
| Facility | | $7,016.83 | $10,547.70 | $16,866.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,206.11 / $14,032.55 / $21,319.52
| Facility | | $8,206.11 | $14,032.55 | $21,319.52 |