- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,182.48 / $9,257.24 / $18,813.20
| Facility | | $7,182.48 | $9,257.24 | $18,813.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,351.25 / $10,351.25 / $10,895.22
| Facility | | $10,351.25 | $10,351.25 | $10,895.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,339.98 / $9,200.82 / $10,518.92
| Facility | | $7,339.98 | $9,200.82 | $10,518.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,733.16 / $10,148.29 / $13,198.29
| Facility | | $5,733.16 | $10,148.29 | $13,198.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,903.94 / $11,903.94 / $13,196.97
| Facility | | $11,903.94 | $11,903.94 | $13,196.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $8,138.68 / $12,533.76
| Facility | | $1,286.00 | $8,138.68 | $12,533.76 |