- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,186.85 / $15,508.90 / $27,291.20
| Facility | | $9,186.85 | $15,508.90 | $27,291.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,101.03 / $16,101.03 / $16,101.03
| Facility | | $16,101.03 | $16,101.03 | $16,101.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,546.63 / $9,663.46 / $16,024.42
| Facility | | $6,546.63 | $9,663.46 | $16,024.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,356.87 / $14,295.44 / $19,765.50
| Facility | | $8,356.87 | $14,295.44 | $19,765.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,348.75 / $29,348.75 / $34,443.25
| Facility | | $29,348.75 | $29,348.75 | $34,443.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $13,515.89 / $19,305.91
| Facility | | $1,787.00 | $13,515.89 | $19,305.91 |