- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,162.78 / $12,092.00 / $21,278.40
| Facility | | $7,162.78 | $12,092.00 | $21,278.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.97 / $11,187.90 / $15,660.70
| Facility | | $6,303.97 | $11,187.90 | $15,660.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,334.15 / $4,910.43 / $8,011.14
| Facility | | $3,334.15 | $4,910.43 | $8,011.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,403.50 / $11,145.84 / $15,925.68
| Facility | | $6,403.50 | $11,145.84 | $15,925.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,441.90 / $23,441.90 / $27,511.06
| Facility | | $23,441.90 | $23,441.90 | $27,511.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $10,538.04 / $15,052.39
| Facility | | $1,787.00 | $10,538.04 | $15,052.39 |