- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,864.77 / $13,277.00 / $23,363.70
| Facility | | $7,864.77 | $13,277.00 | $23,363.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,709.83 / $8,448.51 / $13,935.67
| Facility | | $5,709.83 | $8,448.51 | $13,935.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,154.24 / $12,238.19 / $17,106.22
| Facility | | $7,154.24 | $12,238.19 | $17,106.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,003.70 / $24,003.70 / $28,170.38
| Facility | | $24,003.70 | $24,003.70 | $28,170.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $11,570.82 / $16,527.59
| Facility | | $1,787.00 | $11,570.82 | $16,527.59 |