- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,097.39 / $13,941.70 / $22,447.90
| Facility | | $6,097.39 | $13,941.70 | $22,447.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,925.36 / $13,925.36 / $13,925.36
| Facility | | $13,925.36 | $13,925.36 | $13,925.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $9,057.59 / $19,906.18
| Facility | | $1,474.01 | $9,057.59 | $19,906.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,092.00 / $13,238.06 / $16,306.47
| Facility | | $10,092.00 | $13,238.06 | $16,306.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,821.51 / $11,928.17 / $25,676.28
| Facility | | $8,821.51 | $11,928.17 | $25,676.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,282.48 / $12,226.08 / $26,007.81
| Facility | | $8,282.48 | $12,226.08 | $26,007.81 |