- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,625.93 / $9,497.51 / $16,712.90
| Facility | | $5,625.93 | $9,497.51 | $16,712.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,102.00 / $8,012.06 / $10,891.13
| Facility | | $3,102.00 | $8,012.06 | $10,891.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,250.97 / $16,471.91 / $27,008.51
| Facility | | $11,250.97 | $16,471.91 | $27,008.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,117.67 / $8,754.37 / $12,602.30
| Facility | | $5,117.67 | $8,754.37 | $12,602.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,818.59 / $17,818.59 / $20,911.64
| Facility | | $17,818.59 | $17,818.59 | $20,911.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $8,276.99 / $11,822.74
| Facility | | $1,787.00 | $8,276.99 | $11,822.74 |