- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,021.12 / $13,767.30 / $22,167.10
| Facility | | $6,021.12 | $13,767.30 | $22,167.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,391.64 / $10,391.64 / $10,391.64
| Facility | | $10,391.64 | $10,391.64 | $10,391.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $7,357.61 / $18,888.06
| Facility | | $1,474.01 | $7,357.61 | $18,888.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,965.76 / $14,394.60 / $20,391.68
| Facility | | $9,965.76 | $14,394.60 | $20,391.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,178.88 / $11,778.96 / $21,766.47
| Facility | | $8,178.88 | $11,778.96 | $21,766.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,178.88 / $12,073.15 / $25,682.49
| Facility | | $8,178.88 | $12,073.15 | $25,682.49 |