- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,821.09 / $17,882.90 / $28,793.80
| Facility | | $7,821.09 | $17,882.90 | $28,793.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,099.17 / $14,099.17 / $16,274.30
| Facility | | $14,099.17 | $14,099.17 | $16,274.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,242.69 / $26,417.15
| Facility | | $1,474.01 | $6,242.69 | $26,417.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,122.00 / $17,710.47 / $26,487.64
| Facility | | $12,122.00 | $17,710.47 | $26,487.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,315.31 / $15,682.33 / $32,934.83
| Facility | | $11,315.31 | $15,682.33 | $32,934.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,623.90 / $15,682.33 / $33,360.08
| Facility | | $10,623.90 | $15,682.33 | $33,360.08 |