- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,274.40 / $9,221.16 / $14,236.70
| Facility | | $6,274.40 | $9,221.16 | $14,236.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,736.83 / $16,736.83 / $21,053.08
| Facility | | $16,736.83 | $16,736.83 | $21,053.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,171.45 / $18,725.18 / $24,006.65
| Facility | | $13,171.45 | $18,725.18 | $24,006.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,061.61 / $13,652.97 / $17,268.54
| Facility | | $7,061.61 | $13,652.97 | $17,268.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,274.40 / $9,431.64 / $15,081.60
| Facility | | $6,274.40 | $9,431.64 | $15,081.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,337.84 / $12,547.79 / $19,063.75
| Facility | | $7,337.84 | $12,547.79 | $19,063.75 |