- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,722.91 / $15,085.40 / $22,996.90
| Facility | | $7,722.91 | $15,085.40 | $22,996.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,602.57 / $15,155.75 / $16,191.29
| Facility | | $14,602.57 | $15,155.75 | $16,191.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,449.39 / $13,553.67 / $21,310.76
| Facility | | $8,449.39 | $13,553.67 | $21,310.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,218.87 / $9,218.87 / $9,218.87
| Facility | | $9,218.87 | $9,218.87 | $9,218.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,307.84 / $13,813.10 / $30,738.48
| Facility | | $5,307.84 | $13,813.10 | $30,738.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $13,484.71 / $27,315.82
| Facility | | $3,308.00 | $13,484.71 | $27,315.82 |