- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,532.67 / $11,028.20 / $19,406.50
| Facility | | $6,532.67 | $11,028.20 | $19,406.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,612.54 / $10,612.54 / $13,553.31
| Facility | | $10,612.54 | $10,612.54 | $13,553.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,271.08 / $7,782.86 / $12,673.08
| Facility | | $5,271.08 | $7,782.86 | $12,673.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,942.48 / $10,165.33 / $14,633.42
| Facility | | $5,942.48 | $10,165.33 | $14,633.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,707.09 / $20,707.09 / $24,301.54
| Facility | | $20,707.09 | $20,707.09 | $24,301.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,158.00 / $10,134.74 / $16,462.59
| Facility | | $3,158.00 | $10,134.74 | $16,462.59 |