- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,836.69 / $14,917.80 / $26,251.00
| Facility | | $8,836.69 | $14,917.80 | $26,251.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,604.53 / $8,093.11 / $13,203.51
| Facility | | $5,604.53 | $8,093.11 | $13,203.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,807.84 / $13,750.57 / $19,133.65
| Facility | | $7,807.84 | $13,750.57 | $19,133.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,902.05 / $24,902.05 / $29,224.67
| Facility | | $24,902.05 | $24,902.05 | $29,224.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $13,000.73 / $18,570.06
| Facility | | $1,787.00 | $13,000.73 | $18,570.06 |