- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,301.75 / $11,127.20 / $18,927.59
| Facility | | $5,301.75 | $11,127.20 | $18,927.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,852.99 / $19,072.95 / $24,731.74
| Facility | | $12,852.99 | $19,072.95 | $24,731.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,013.39 / $16,939.89 / $24,286.64
| Facility | | $12,013.39 | $16,939.89 | $24,286.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,515.98 / $16,363.66 / $34,315.12
| Facility | | $8,515.98 | $16,363.66 | $34,315.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,745.66 / $7,745.66 / $7,745.66
| Facility | | $7,745.66 | $7,745.66 | $7,745.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,013.39 / $17,648.00 / $24,292.63
| Facility | | $12,013.39 | $17,648.00 | $24,292.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,346.00 / $14,238.00 / $21,392.23
| Facility | | $4,346.00 | $14,238.00 | $21,392.23 |