- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,280.27 / $11,227.00 / $18,850.90
| Facility | | $5,280.27 | $11,227.00 | $18,850.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,386.56 / $18,380.80 / $23,834.24
| Facility | | $12,386.56 | $18,380.80 | $23,834.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,964.71 / $16,871.25 / $24,188.22
| Facility | | $11,964.71 | $16,871.25 | $24,188.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,481.46 / $16,297.35 / $34,176.06
| Facility | | $8,481.46 | $16,297.35 | $34,176.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,964.71 / $17,648.00 / $24,194.19
| Facility | | $11,964.71 | $17,648.00 | $24,194.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,790.53 / $14,238.00 / $21,305.54
| Facility | | $4,790.53 | $14,238.00 | $21,305.54 |