- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,184.11 / $16,426.50 / $26,448.70
| Facility | | $7,184.11 | $16,426.50 | $26,448.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,987.52 / $11,987.52 / $12,639.91
| Facility | | $11,987.52 | $11,987.52 | $12,639.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $8,495.87 / $22,283.53
| Facility | | $1,474.01 | $8,495.87 | $22,283.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,890.65 / $17,174.93 / $24,330.36
| Facility | | $11,890.65 | $17,174.93 | $24,330.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,393.74 / $14,405.09 / $30,252.47
| Facility | | $10,393.74 | $14,405.09 | $30,252.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,758.64 / $14,405.09 / $30,643.09
| Facility | | $9,758.64 | $14,405.09 | $30,643.09 |