- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,847.39 / $9,871.37 / $17,370.80
| Facility | | $5,847.39 | $9,871.37 | $17,370.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,406.45 / $8,406.45 / $9,699.20
| Facility | | $8,406.45 | $8,406.45 | $9,699.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,056.34 / $5,987.55 / $9,928.85
| Facility | | $4,056.34 | $5,987.55 | $9,928.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,319.12 / $9,098.99 / $13,098.38
| Facility | | $5,319.12 | $9,098.99 | $13,098.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,621.55 / $18,621.55 / $21,853.97
| Facility | | $18,621.55 | $18,621.55 | $21,853.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $8,602.81 / $12,288.13
| Facility | | $1,787.00 | $8,602.81 | $12,288.13 |