- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,310.37 / $10,653.00 / $18,746.09
| Facility | | $6,310.37 | $10,653.00 | $18,746.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,527.00 / $10,297.27 / $12,030.43
| Facility | | $3,527.00 | $10,297.27 | $12,030.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.50 / $5,358.98 / $8,800.57
| Facility | | $3,630.50 | $5,358.98 | $8,800.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,740.27 / $9,819.42 / $14,135.47
| Facility | | $5,740.27 | $9,819.42 | $14,135.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,893.55 / $19,893.55 / $23,346.77
| Facility | | $19,893.55 | $19,893.55 | $23,346.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $9,283.95 / $13,261.07
| Facility | | $1,787.00 | $9,283.95 | $13,261.07 |