- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,843.21 / $12,686.60 / $25,782.50
| Facility | | $9,843.21 | $12,686.60 | $25,782.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,783.27 / $10,990.96 / $15,917.21
| Facility | | $9,783.27 | $10,990.96 | $15,917.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,961.29 / $12,486.70 / $14,275.53
| Facility | | $9,961.29 | $12,486.70 | $14,275.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,856.99 / $13,907.70 / $18,087.56
| Facility | | $7,856.99 | $13,907.70 | $18,087.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,639.60 / $16,785.61 / $18,167.23
| Facility | | $12,639.60 | $16,785.61 | $18,167.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $11,153.63 / $17,176.87
| Facility | | $1,286.00 | $11,153.63 | $17,176.87 |