- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,029.91 / $11,867.60 / $20,883.59
| Facility | | $7,029.91 | $11,867.60 | $20,883.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,187.03 / $10,309.40 / $14,684.00
| Facility | | $6,187.03 | $10,309.40 | $14,684.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,566.74 / $9,852.36 / $16,073.65
| Facility | | $6,566.74 | $9,852.36 | $16,073.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,394.80 / $10,939.07 / $15,702.22
| Facility | | $6,394.80 | $10,939.07 | $15,702.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,795.30 / $22,795.30 / $26,752.22
| Facility | | $22,795.30 | $22,795.30 | $26,752.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $10,342.54 / $14,773.15
| Facility | | $1,787.00 | $10,342.54 | $14,773.15 |