- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,776.49 / $12,412.90 / $17,575.30
| Facility | | $6,776.49 | $12,412.90 | $17,575.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,979.85 / $10,979.85 / $10,979.85
| Facility | | $10,979.85 | $10,979.85 | $10,979.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,197.03 / $11,667.81 / $18,467.66
| Facility | | $7,197.03 | $11,667.81 | $18,467.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,045.50 / $10,681.41 / $19,866.18
| Facility | | $7,045.50 | $10,681.41 | $19,866.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,230.75 / $10,490.90 / $23,491.79
| Facility | | $5,230.75 | $10,490.90 | $23,491.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $10,305.65 / $20,876.03
| Facility | | $3,308.00 | $10,305.65 | $20,876.03 |