- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,424.49 / $11,821.80 / $16,924.00
| Facility | | $8,424.49 | $11,821.80 | $16,924.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,871.97 / $4,871.97 / $4,871.97
| Facility | | $4,871.97 | $4,871.97 | $4,871.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,723.11 / $10,642.41 / $15,855.69
| Facility | | $6,723.11 | $10,642.41 | $15,855.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,349.27 / $10,146.11 / $18,364.00
| Facility | | $7,349.27 | $10,146.11 | $18,364.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $78.12 / $108.10 / $182.22
| Facility | | $78.12 | $108.10 | $182.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,094.85 / $11,202.96 / $18,437.46
| Facility | | $8,094.85 | $11,202.96 | $18,437.46 |