- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,080.30 / $9,337.03 / $15,501.70
| Facility | | $6,080.30 | $9,337.03 | $15,501.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,988.00 / $7,703.14 / $15,785.85
| Facility | | $2,988.00 | $7,703.14 | $15,785.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,525.74 / $8,277.89 / $14,022.92
| Facility | | $5,525.74 | $8,277.89 | $14,022.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,048.23 / $9,959.02 / $14,319.86
| Facility | | $8,048.23 | $9,959.02 | $14,319.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,003.13 / $9,998.25 / $24,708.95
| Facility | | $5,003.13 | $9,998.25 | $24,708.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,003.13 / $9,545.95 / $13,416.38
| Facility | | $5,003.13 | $9,545.95 | $13,416.38 |