- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,140.60 / $11,754.00 / $18,925.40
| Facility | | $5,140.60 | $11,754.00 | $18,925.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,788.86 / $16,334.24
| Facility | | $1,474.01 | $5,788.86 | $16,334.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,508.37 / $12,289.55 / $17,409.62
| Facility | | $8,508.37 | $12,289.55 | $17,409.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,437.25 / $10,307.58 / $21,647.20
| Facility | | $7,437.25 | $10,307.58 | $21,647.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,814.97 / $9,773.00 / $18,583.36
| Facility | | $6,814.97 | $9,773.00 | $18,583.36 |