- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,284.44 / $13,189.70 / $22,435.80
| Facility | | $6,284.44 | $13,189.70 | $22,435.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,537.41 / $23,021.95 / $29,852.38
| Facility | | $15,537.41 | $23,021.95 | $29,852.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,240.09 / $18,005.07 / $28,788.21
| Facility | | $14,240.09 | $18,005.07 | $28,788.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,094.43 / $19,396.70 / $40,675.49
| Facility | | $10,094.43 | $19,396.70 | $40,675.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,312.74 / $7,992.10 / $9,034.16
| Facility | | $7,312.74 | $7,992.10 | $9,034.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,240.09 / $19,268.61 / $28,795.32
| Facility | | $14,240.09 | $19,268.61 | $28,795.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,870.00 / $15,806.00 / $24,765.76
| Facility | | $4,870.00 | $15,806.00 | $24,765.76 |