- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,920.02 / $18,171.09 / $25,728.30
| Facility | | $9,920.02 | $18,171.09 | $25,728.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,434.09 / $11,434.09 / $11,434.09
| Facility | | $11,434.09 | $11,434.09 | $11,434.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,022.28 / $20,940.66 / $33,560.58
| Facility | | $13,022.28 | $20,940.66 | $33,560.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,313.82 / $16,345.84 / $29,081.85
| Facility | | $10,313.82 | $16,345.84 | $29,081.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,563.34 / $15,841.70 / $34,389.33
| Facility | | $6,563.34 | $15,841.70 | $34,389.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $15,086.31 / $30,560.16
| Facility | | $3,308.00 | $15,086.31 | $30,560.16 |