- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,616.90 / $14,546.80 / $25,598.10
| Facility | | $8,616.90 | $14,546.80 | $25,598.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,802.24 / $7,802.24 / $7,802.24
| Facility | | $7,802.24 | $7,802.24 | $7,802.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,546.63 / $9,663.46 / $15,978.00
| Facility | | $6,546.63 | $9,663.46 | $15,978.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,838.42 / $13,408.56 / $18,657.75
| Facility | | $7,838.42 | $13,408.56 | $18,657.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,827.65 / $27,827.65 / $32,658.11
| Facility | | $27,827.65 | $27,827.65 | $32,658.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $12,677.37 / $18,108.18
| Facility | | $1,787.00 | $12,677.37 | $18,108.18 |