- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,329.10 / $13,124.30 / $17,135.59
| Facility | | $6,329.10 | $13,124.30 | $17,135.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $11,830.36 / $32,093.91
| Facility | | $5,840.42 | $11,830.36 | $32,093.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,415.66 / $12,261.95 / $18,527.95
| Facility | | $7,415.66 | $12,261.95 | $18,527.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,759.74 / $14,759.74 / $14,759.74
| Facility | | $14,759.74 | $14,759.74 | $14,759.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,684.51 / $12,352.81 / $19,075.64
| Facility | | $10,684.51 | $12,352.81 | $19,075.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $11,830.36 / $32,093.91
| Facility | | $5,840.42 | $11,830.36 | $32,093.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,750.00 / $25,081.68
| Facility | | $5,840.42 | $9,750.00 | $25,081.68 |