- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,956.30 / $14,513.10 / $25,392.40
| Facility | | $10,956.30 | $14,513.10 | $25,392.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,840.71 / $11,514.56 / $19,709.93
| Facility | | $6,840.71 | $11,514.56 | $19,709.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,549.66 / $11,876.72 / $25,110.36
| Facility | | $5,549.66 | $11,876.72 | $25,110.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,396.60 / $14,740.27 / $22,671.00
| Facility | | $10,396.60 | $14,740.27 | $22,671.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,547.79 / $6,885.38 / $11,952.37
| Facility | | $3,547.79 | $6,885.38 | $11,952.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $14,956.45 / $22,844.12
| Facility | | $3,496.00 | $14,956.45 | $22,844.12 |