- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,952.14 / $15,896.10 / $25,594.70
| Facility | | $6,952.14 | $15,896.10 | $25,594.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,816.34 / $18,313.68 / $19,475.93
| Facility | | $13,816.34 | $18,313.68 | $19,475.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $10,754.65 / $23,075.62
| Facility | | $1,474.01 | $10,754.65 | $23,075.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,506.72 / $16,620.38 / $23,544.76
| Facility | | $11,506.72 | $16,620.38 | $23,544.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,058.14 / $17,379.03 / $32,627.00
| Facility | | $10,058.14 | $17,379.03 | $32,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,058.14 / $17,899.78 / $30,154.59
| Facility | | $10,058.14 | $17,899.78 | $30,154.59 |