- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,186.18 / $15,088.70 / $21,347.90
| Facility | | $7,186.18 | $15,088.70 | $21,347.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,336.21 / $10,828.97 / $17,905.09
| Facility | | $7,336.21 | $10,828.97 | $17,905.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,536.96 / $11,182.25 / $15,965.03
| Facility | | $6,536.96 | $11,182.25 | $15,965.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,637.25 / $21,637.25 / $25,393.15
| Facility | | $21,637.25 | $21,637.25 | $25,393.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $10,572.47 / $15,101.56
| Facility | | $1,787.00 | $10,572.47 | $15,101.56 |