- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,098.44 / $11,983.30 / $21,087.20
| Facility | | $7,098.44 | $11,983.30 | $21,087.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,267.35 / $11,745.37 / $19,288.36
| Facility | | $8,267.35 | $11,745.37 | $19,288.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,457.14 / $11,045.71 / $15,817.47
| Facility | | $6,457.14 | $11,045.71 | $15,817.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,700.85 / $21,700.85 / $25,467.79
| Facility | | $21,700.85 | $21,700.85 | $25,467.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $10,443.37 / $14,917.16
| Facility | | $1,787.00 | $10,443.37 | $14,917.16 |