- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.36 / $11,142.50 / $19,607.59
| Facility | | $6,600.36 | $11,142.50 | $19,607.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,668.92 / $10,512.00 / $11,422.16
| Facility | | $5,668.92 | $10,512.00 | $11,422.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,176.48 / $9,042.64 / $14,951.50
| Facility | | $6,176.48 | $9,042.64 | $14,951.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,004.06 / $10,270.66 / $14,785.06
| Facility | | $6,004.06 | $10,270.66 | $14,785.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,242.40 / $21,242.40 / $24,929.76
| Facility | | $21,242.40 | $21,242.40 | $24,929.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $9,710.59 / $13,870.47
| Facility | | $1,787.00 | $9,710.59 | $13,870.47 |