- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,156.43 / $13,769.40 / $24,230.20
| Facility | | $8,156.43 | $13,769.40 | $24,230.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,305.78 / $13,614.08 / $24,280.10
| Facility | | $8,305.78 | $13,614.08 | $24,280.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,097.70 / $13,035.22 / $20,891.20
| Facility | | $9,097.70 | $13,035.22 | $20,891.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,419.55 / $12,692.03 / $17,660.72
| Facility | | $7,419.55 | $12,692.03 | $17,660.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,290.65 / $26,290.65 / $30,854.31
| Facility | | $26,290.65 | $26,290.65 | $30,854.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $11,999.92 / $17,140.50
| Facility | | $1,787.00 | $11,999.92 | $17,140.50 |