- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,566.83 / $17,757.91 / $17,757.91
| Facility | | $15,566.83 | $17,757.91 | $17,757.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,098.68 / $9,346.39 / $14,774.62
| Facility | | $5,098.68 | $9,346.39 | $14,774.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,950.60 / $13,216.02 / $28,883.00
| Facility | | $7,950.60 | $13,216.02 | $28,883.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.42 / $9,113.69 / $13,389.07
| Facility | | $6,025.42 | $9,113.69 | $13,389.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,422.33 / $7,422.33 / $12,916.90
| Facility | | $7,422.33 | $7,422.33 | $12,916.90 |