- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,276.71 / $13,329.20 / $18,872.70
| Facility | | $7,276.71 | $13,329.20 | $18,872.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,346.27 / $12,346.27 / $12,346.27
| Facility | | $12,346.27 | $12,346.27 | $12,346.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,962.34 / $13,032.70 / $21,219.58
| Facility | | $7,962.34 | $13,032.70 | $21,219.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,565.58 / $11,990.30 / $21,332.64
| Facility | | $7,565.58 | $11,990.30 | $21,332.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,264.00 / $11,312.83 / $25,225.89
| Facility | | $5,264.00 | $11,312.83 | $25,225.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $11,066.38 / $22,417.04
| Facility | | $3,308.00 | $11,066.38 | $22,417.04 |