- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,591.00 / $14,503.00 / $25,521.10
| Facility | | $8,591.00 | $14,503.00 | $25,521.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,121.78 / $13,121.78 / $14,118.11
| Facility | | $13,121.78 | $13,121.78 | $14,118.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,705.84 / $14,448.87 / $23,757.33
| Facility | | $9,705.84 | $14,448.87 | $23,757.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,814.86 / $13,368.25 / $18,601.66
| Facility | | $7,814.86 | $13,368.25 | $18,601.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,113.85 / $28,113.85 / $32,993.99
| Facility | | $28,113.85 | $28,113.85 | $32,993.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $12,639.26 / $18,053.74
| Facility | | $1,787.00 | $12,639.26 | $18,053.74 |