- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,818.16 / $11,016.70 / $17,738.30
| Facility | | $4,818.16 | $11,016.70 | $17,738.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,435.92 / $14,435.92 / $14,435.92
| Facility | | $14,435.92 | $14,435.92 | $14,435.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,930.56 / $15,449.45
| Facility | | $1,474.01 | $5,930.56 | $15,449.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,974.70 / $11,518.70 / $16,317.62
| Facility | | $7,974.70 | $11,518.70 | $16,317.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,544.82 / $9,661.04 / $26,208.00
| Facility | | $6,544.82 | $9,661.04 | $26,208.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,051.10 / $9,661.04 / $20,551.38
| Facility | | $6,051.10 | $9,661.04 | $20,551.38 |