- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,388.86 / $9,523.24 / $19,353.70
| Facility | | $7,388.86 | $9,523.24 | $19,353.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,190.76 / $10,662.04 / $11,351.39
| Facility | | $8,190.76 | $10,662.04 | $11,351.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,707.05 / $9,660.95 / $11,044.96
| Facility | | $7,707.05 | $9,660.95 | $11,044.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,897.89 / $10,439.89 / $13,577.52
| Facility | | $5,897.89 | $10,439.89 | $13,577.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,261.35 / $12,261.35 / $13,054.10
| Facility | | $12,261.35 | $12,261.35 | $13,054.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $8,372.53 / $12,893.91
| Facility | | $1,286.00 | $8,372.53 | $12,893.91 |