- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,728.05 / $14,155.90 / $20,043.30
| Facility | | $7,728.05 | $14,155.90 | $20,043.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,833.26 / $11,833.26 / $11,833.26
| Facility | | $11,833.26 | $11,833.26 | $11,833.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,390.37 / $13,607.80 / $21,885.92
| Facility | | $8,390.37 | $13,607.80 | $21,885.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,034.84 / $12,734.00 / $22,655.81
| Facility | | $8,034.84 | $12,734.00 | $22,655.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,264.00 / $11,711.98 / $26,790.54
| Facility | | $5,264.00 | $11,711.98 | $26,790.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $11,752.78 / $23,807.47
| Facility | | $3,308.00 | $11,752.78 | $23,807.47 |