- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,565.92 / $14,460.70 / $25,446.60
| Facility | | $8,565.92 | $14,460.70 | $25,446.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,379.85 / $14,379.85 / $14,678.78
| Facility | | $14,379.85 | $14,379.85 | $14,678.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,423.65 / $10,984.36 / $18,171.14
| Facility | | $7,423.65 | $10,984.36 | $18,171.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,792.05 / $13,329.23 / $18,547.38
| Facility | | $7,792.05 | $13,329.23 | $18,547.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,385.10 / $27,385.10 / $32,138.74
| Facility | | $27,385.10 | $27,385.10 | $32,138.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $12,602.38 / $18,001.05
| Facility | | $1,787.00 | $12,602.38 | $18,001.05 |