- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,209.45 / $10,933.50 / $18,563.00
| Facility | | $5,209.45 | $10,933.50 | $18,563.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,809.07 / $20,491.72 / $26,571.45
| Facility | | $13,809.07 | $20,491.72 | $26,571.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,371.39 / $18,524.13 / $23,869.71
| Facility | | $11,371.39 | $18,524.13 | $23,869.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,367.71 / $16,078.78 / $33,717.69
| Facility | | $8,367.71 | $16,078.78 | $33,717.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,529.05 / $16,260.64 / $23,869.71
| Facility | | $7,529.05 | $16,260.64 | $23,869.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,654.43 / $14,238.00 / $21,019.80
| Facility | | $4,654.43 | $14,238.00 | $21,019.80 |