- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,167.30 / $13,787.70 / $24,262.40
| Facility | | $8,167.30 | $13,787.70 | $24,262.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,583.35 / $9,894.61 / $16,067.63
| Facility | | $6,583.35 | $9,894.61 | $16,067.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,429.43 / $12,708.94 / $17,684.24
| Facility | | $7,429.43 | $12,708.94 | $17,684.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,326.05 / $25,326.05 / $29,722.27
| Facility | | $25,326.05 | $25,326.05 | $29,722.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $11,772.56 / $17,163.34
| Facility | | $1,787.00 | $11,772.56 | $17,163.34 |