- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,454.27 / $15,960.40 / $28,085.70
| Facility | | $9,454.27 | $15,960.40 | $28,085.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,013.24 / $8,897.45 / $14,576.48
| Facility | | $6,013.24 | $8,897.45 | $14,576.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,600.14 / $14,711.57 / $20,314.04
| Facility | | $8,600.14 | $14,711.57 | $20,314.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,590.85 / $28,590.85 / $33,553.79
| Facility | | $28,590.85 | $28,590.85 | $33,553.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $13,909.33 / $19,867.89
| Facility | | $1,787.00 | $13,909.33 | $19,867.89 |