- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,202.67 / $11,895.90 / $19,153.90
| Facility | | $5,202.67 | $11,895.90 | $19,153.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $8,400.00 / $16,906.09
| Facility | | $1,474.01 | $8,400.00 | $16,906.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,611.10 / $12,437.93 / $17,619.83
| Facility | | $8,611.10 | $12,437.93 | $17,619.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,527.05 / $10,432.04 / $21,908.57
| Facility | | $7,527.05 | $10,432.04 | $21,908.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,067.12 / $10,432.04 / $22,191.45
| Facility | | $7,067.12 | $10,432.04 | $22,191.45 |