- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,184.51 / $12,128.60 / $21,342.90
| Facility | | $7,184.51 | $12,128.60 | $21,342.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,574.05 / $11,180.04 / $18,539.27
| Facility | | $7,574.05 | $11,180.04 | $18,539.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,535.44 / $11,179.65 / $15,962.22
| Facility | | $6,535.44 | $11,179.65 | $15,962.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,312.80 / $25,312.80 / $29,706.72
| Facility | | $25,312.80 | $25,312.80 | $29,706.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $10,570.01 / $15,098.05
| Facility | | $1,787.00 | $10,570.01 | $15,098.05 |