- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,503.42 / $10,978.80 / $19,319.59
| Facility | | $6,503.42 | $10,978.80 | $19,319.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,463.74 / $10,597.52 / $13,265.34
| Facility | | $6,463.74 | $10,597.52 | $13,265.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,000.70 / $5,953.40 / $9,602.43
| Facility | | $4,000.70 | $5,953.40 | $9,602.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,915.88 / $10,119.81 / $14,567.90
| Facility | | $5,915.88 | $10,119.81 | $14,567.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,707.09 / $20,707.09 / $24,301.54
| Facility | | $20,707.09 | $20,707.09 | $24,301.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $9,567.96 / $13,666.75
| Facility | | $1,787.00 | $9,567.96 | $13,666.75 |