- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,283.96 / $12,296.50 / $21,638.30
| Facility | | $7,283.96 | $12,296.50 | $21,638.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,911.68 / $10,911.68 / $11,860.59
| Facility | | $10,911.68 | $10,911.68 | $11,860.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,464.68 / $6,590.31 / $10,928.37
| Facility | | $4,464.68 | $6,590.31 | $10,928.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,625.90 / $11,334.40 / $16,129.47
| Facility | | $6,625.90 | $11,334.40 | $16,129.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,089.45 / $23,089.45 / $27,097.43
| Facility | | $23,089.45 | $23,089.45 | $27,097.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $10,716.32 / $15,307.04
| Facility | | $1,787.00 | $10,716.32 | $15,307.04 |