- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,567.51 / $11,312.80 / $19,876.40
| Facility | | $5,567.51 | $11,312.80 | $19,876.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,620.43 / $20,181.54 / $27,956.91
| Facility | | $13,620.43 | $20,181.54 | $27,956.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,615.59 / $17,646.00 / $25,504.07
| Facility | | $12,615.59 | $17,646.00 | $25,504.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,942.87 / $17,183.93 / $36,035.25
| Facility | | $8,942.87 | $17,183.93 | $36,035.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,523.95 / $6,523.95 / $6,523.95
| Facility | | $6,523.95 | $6,523.95 | $6,523.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,615.59 / $17,648.00 / $25,510.36
| Facility | | $12,615.59 | $17,648.00 | $25,510.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,870.00 / $14,655.22 / $22,464.57
| Facility | | $4,870.00 | $14,655.22 | $22,464.57 |