- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,947.25 / $12,725.70 / $18,018.20
| Facility | | $6,947.25 | $12,725.70 | $18,018.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,842.69 / $10,842.69 / $13,489.62
| Facility | | $10,842.69 | $10,842.69 | $13,489.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,464.90 / $12,082.77 / $19,187.59
| Facility | | $7,464.90 | $12,082.77 | $19,187.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,223.04 / $11,447.42 / $20,366.78
| Facility | | $7,223.04 | $11,447.42 | $20,366.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,264.00 / $10,800.63 / $24,083.76
| Facility | | $5,264.00 | $10,800.63 | $24,083.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $10,565.34 / $21,402.09
| Facility | | $3,308.00 | $10,565.34 | $21,402.09 |