- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,615.05 / $12,838.80 / $20,672.09
| Facility | | $5,615.05 | $12,838.80 | $20,672.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,490.75 / $9,938.68 / $16,520.07
| Facility | | $8,490.75 | $9,938.68 | $16,520.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,665.06 / $18,105.79
| Facility | | $1,474.01 | $6,665.06 | $18,105.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,293.66 / $13,423.81 / $19,016.45
| Facility | | $9,293.66 | $13,423.81 | $19,016.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,627.29 / $11,258.92 / $23,645.13
| Facility | | $7,627.29 | $11,258.92 | $23,645.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,627.29 / $12,381.00 / $20,298.50
| Facility | | $7,627.29 | $12,381.00 | $20,298.50 |