- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,570.91 / $12,335.60 / $25,069.20
| Facility | | $9,570.91 | $12,335.60 | $25,069.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,041.16 / $12,235.57 / $14,542.22
| Facility | | $8,041.16 | $12,235.57 | $14,542.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,337.92 / $11,705.28 / $13,382.16
| Facility | | $9,337.92 | $11,705.28 | $13,382.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,639.63 / $13,522.95 / $17,587.18
| Facility | | $7,639.63 | $13,522.95 | $17,587.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,247.33 / $14,070.91 / $16,723.55
| Facility | | $9,247.33 | $14,070.91 | $16,723.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $10,845.07 / $16,701.68
| Facility | | $1,286.00 | $10,845.07 | $16,701.68 |