- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,903.01 / $8,897.04 / $18,081.09
| Facility | | $6,903.01 | $8,897.04 | $18,081.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,129.97 / $7,129.97 / $10,533.45
| Facility | | $7,129.97 | $7,129.97 | $10,533.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,867.83 / $8,608.96 / $9,842.28
| Facility | | $6,867.83 | $8,608.96 | $9,842.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,510.08 / $9,753.41 / $12,684.73
| Facility | | $5,510.08 | $9,753.41 | $12,684.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,199.46 / $8,199.46 / $12,113.47
| Facility | | $8,199.46 | $8,199.46 | $12,113.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $8,462.59 / $12,046.07
| Facility | | $1,286.00 | $8,462.59 | $12,046.07 |