- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,030.74 / $14,762.30 / $20,886.09
| Facility | | $7,030.74 | $14,762.30 | $20,886.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,620.73 / $5,396.18 / $8,790.20
| Facility | | $3,620.73 | $5,396.18 | $8,790.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,212.16 / $10,940.37 / $15,703.63
| Facility | | $6,212.16 | $10,940.37 | $15,703.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,772.20 / $24,772.20 / $29,072.28
| Facility | | $24,772.20 | $24,772.20 | $29,072.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $10,343.78 / $14,774.91
| Facility | | $1,787.00 | $10,343.78 | $14,774.91 |