- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,421.00 / $10,637.90 / $17,991.90
| Facility | | $2,421.00 | $10,637.90 | $17,991.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,272.58 / $11,741.89 / $13,356.99
| Facility | | $8,272.58 | $11,741.89 | $13,356.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,142.54 / $11,351.43 / $18,896.16
| Facility | | $4,142.54 | $11,351.43 | $18,896.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,196.87 / $15,675.42 / $27,960.53
| Facility | | $11,196.87 | $15,675.42 | $27,960.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,936.00 / $14,153.00 / $23,503.00
| Facility | | $9,936.00 | $14,153.00 | $23,503.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,872.74 / $14,010.00 / $23,737.97
| Facility | | $8,872.74 | $14,010.00 | $23,737.97 |