- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,765.49 / $9,733.11 / $17,127.50
| Facility | | $5,765.49 | $9,733.11 | $17,127.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,486.78 / $9,486.78 / $13,782.87
| Facility | | $9,486.78 | $9,486.78 | $13,782.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,863.16 / $10,217.04 / $16,750.55
| Facility | | $6,863.16 | $10,217.04 | $16,750.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,244.62 / $8,971.54 / $12,914.93
| Facility | | $5,244.62 | $8,971.54 | $12,914.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,396.30 / $18,396.30 / $21,589.62
| Facility | | $18,396.30 | $18,396.30 | $21,589.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $8,482.32 / $12,116.02
| Facility | | $1,787.00 | $8,482.32 | $12,116.02 |