- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,116.82 / $12,014.40 / $21,141.80
| Facility | | $7,116.82 | $12,014.40 | $21,141.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,373.96 / $9,411.29 / $15,474.36
| Facility | | $6,373.96 | $9,411.29 | $15,474.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,473.86 / $11,074.32 / $15,848.39
| Facility | | $6,473.86 | $11,074.32 | $15,848.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,175.20 / $22,175.20 / $26,024.48
| Facility | | $22,175.20 | $22,175.20 | $26,024.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $10,470.42 / $14,955.80
| Facility | | $1,787.00 | $10,470.42 | $14,955.80 |