- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,420.68 / $10,839.20 / $19,073.80
| Facility | | $6,420.68 | $10,839.20 | $19,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,891.54 / $9,891.54 / $15,014.26
| Facility | | $9,891.54 | $9,891.54 | $15,014.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,272.28 / $9,067.02 / $14,776.63
| Facility | | $6,272.28 | $9,067.02 | $14,776.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.62 / $9,991.07 / $14,382.58
| Facility | | $5,840.62 | $9,991.07 | $14,382.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,635.55 / $20,635.55 / $24,217.57
| Facility | | $20,635.55 | $20,635.55 | $24,217.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $9,446.25 / $13,492.88
| Facility | | $1,787.00 | $9,446.25 | $13,492.88 |