- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,377.56 / $12,454.50 / $21,916.40
| Facility | | $7,377.56 | $12,454.50 | $21,916.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,848.00 / $11,347.12 / $15,568.14
| Facility | | $5,848.00 | $11,347.12 | $15,568.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,371.85 / $6,505.71 / $10,613.74
| Facility | | $4,371.85 | $6,505.71 | $10,613.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,611.56 / $12,902.46 / $16,613.41
| Facility | | $7,611.56 | $12,902.46 | $16,613.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,378.30 / $23,378.30 / $27,436.42
| Facility | | $23,378.30 | $23,378.30 | $27,436.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $10,634.21 / $15,503.73
| Facility | | $1,787.00 | $10,634.21 | $15,503.73 |