- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $6,606.93 / $17,782.79
| Facility | | $4,265.80 | $6,606.93 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $6,025.60 / $11,481.54
| Facility | | $3,090.30 | $6,025.60 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $19,952.62 / $30,902.95
| Facility | | $13,803.84 | $19,952.62 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $8,912.51 / $12,022.64
| Facility | | $5,623.41 | $8,912.51 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48,977.88 / $48,977.88 / $48,977.88
| Facility | | $48,977.88 | $48,977.88 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $10,232.93 / $16,982.44
| Facility | | $3,801.89 | $10,232.93 | $16,982.44 |