- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,419.68 / $14,213.80 / $25,012.20
| Facility | | $8,419.68 | $14,213.80 | $25,012.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,370.19 / $12,370.19 / $14,215.22
| Facility | | $12,370.19 | $12,370.19 | $14,215.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,206.49 / $9,183.39 / $15,044.92
| Facility | | $6,206.49 | $9,183.39 | $15,044.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,659.02 / $13,101.66 / $18,230.71
| Facility | | $7,659.02 | $13,101.66 | $18,230.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,118.40 / $26,118.40 / $30,652.16
| Facility | | $26,118.40 | $26,118.40 | $30,652.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $12,387.21 / $17,693.72
| Facility | | $1,787.00 | $12,387.21 | $17,693.72 |