- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,407.28 / $12,363.80 / $19,907.20
| Facility | | $5,407.28 | $12,363.80 | $19,907.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,674.00 / $18,507.96
| Facility | | $1,474.01 | $6,674.00 | $18,507.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,949.77 / $12,927.10 / $18,312.79
| Facility | | $8,949.77 | $12,927.10 | $18,312.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,823.08 / $10,842.32 / $22,770.20
| Facility | | $7,823.08 | $10,842.32 | $22,770.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,345.06 / $10,842.32 / $23,064.21
| Facility | | $7,345.06 | $10,842.32 | $23,064.21 |