- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,514.60 / $8,042.13 / $13,054.90
| Facility | | $5,514.60 | $8,042.13 | $13,054.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,929.04 / $10,863.48 / $18,070.09
| Facility | | $9,929.04 | $10,863.48 | $18,070.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,789.00 / $18,178.11 / $23,305.27
| Facility | | $12,789.00 | $18,178.11 | $23,305.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,475.44 / $12,519.65 / $15,835.09
| Facility | | $6,475.44 | $12,519.65 | $15,835.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,753.57 / $8,648.73 / $13,829.70
| Facility | | $5,753.57 | $8,648.73 | $13,829.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,572.46 / $11,506.21 / $17,481.28
| Facility | | $7,572.46 | $11,506.21 | $17,481.28 |