- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,671.26 / $15,253.80 / $24,560.60
| Facility | | $6,671.26 | $15,253.80 | $24,560.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,815.92 / $11,686.38 / $13,489.30
| Facility | | $9,815.92 | $11,686.38 | $13,489.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $7,976.62 / $21,647.20
| Facility | | $1,474.01 | $7,976.62 | $21,647.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,041.82 / $15,948.87 / $22,593.50
| Facility | | $11,041.82 | $15,948.87 | $22,593.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,651.76 / $13,192.00 / $28,092.85
| Facility | | $9,651.76 | $13,192.00 | $28,092.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,062.00 / $13,376.76 / $28,455.58
| Facility | | $9,062.00 | $13,376.76 | $28,455.58 |