- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,259.40 / $14,312.10 / $23,044.40
| Facility | | $6,259.40 | $14,312.10 | $23,044.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,688.33 / $12,337.26 / $17,687.54
| Facility | | $10,688.33 | $12,337.26 | $17,687.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $7,004.78 / $19,476.05
| Facility | | $1,474.01 | $7,004.78 | $19,476.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,360.14 / $14,174.09 / $21,198.66
| Facility | | $10,360.14 | $14,174.09 | $21,198.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,055.90 / $12,550.93 / $26,358.50
| Facility | | $9,055.90 | $12,550.93 | $26,358.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,326.91 / $11,900.00 / $22,627.85
| Facility | | $8,326.91 | $11,900.00 | $22,627.85 |