- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,996.17 / $9,017.11 / $18,325.20
| Facility | | $6,996.17 | $9,017.11 | $18,325.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,922.07 / $10,183.75 / $10,844.63
| Facility | | $9,922.07 | $10,183.75 | $10,844.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,898.36 / $8,647.24 / $9,886.03
| Facility | | $6,898.36 | $8,647.24 | $9,886.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,584.44 / $9,885.04 / $12,855.92
| Facility | | $5,584.44 | $9,885.04 | $12,855.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,410.38 / $11,743.39 / $12,471.32
| Facility | | $11,410.38 | $11,743.39 | $12,471.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $7,927.56 / $12,208.63
| Facility | | $1,286.00 | $7,927.56 | $12,208.63 |