- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,207.85 / $14,194.30 / $22,854.60
| Facility | | $6,207.85 | $14,194.30 | $22,854.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $9,232.21 / $19,970.66
| Facility | | $1,474.01 | $9,232.21 | $19,970.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,053.00 / $14,057.36 / $21,024.08
| Facility | | $10,053.00 | $14,057.36 | $21,024.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,981.32 / $12,447.57 / $26,141.43
| Facility | | $8,981.32 | $12,447.57 | $26,141.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,432.53 / $12,447.57 / $26,478.97
| Facility | | $8,432.53 | $12,447.57 | $26,478.97 |