- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,010.60 / $13,743.30 / $22,128.40
| Facility | | $6,010.60 | $13,743.30 | $22,128.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,140.38 / $12,140.38 / $12,140.38
| Facility | | $12,140.38 | $12,140.38 | $12,140.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $7,499.00 / $18,908.41
| Facility | | $1,474.01 | $7,499.00 | $18,908.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,948.35 / $14,369.45 / $20,356.06
| Facility | | $9,948.35 | $14,369.45 | $20,356.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,695.95 / $12,052.06 / $25,310.81
| Facility | | $8,695.95 | $12,052.06 | $25,310.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,164.59 / $12,052.06 / $25,637.62
| Facility | | $8,164.59 | $12,052.06 | $25,637.62 |