- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,543.86 / $12,735.30 / $22,410.40
| Facility | | $7,543.86 | $12,735.30 | $22,410.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,495.35 / $11,063.88 / $18,611.52
| Facility | | $7,495.35 | $11,063.88 | $18,611.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,862.33 / $11,738.83 / $16,566.55
| Facility | | $6,862.33 | $11,738.83 | $16,566.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,579.50 / $26,579.50 / $31,193.30
| Facility | | $26,579.50 | $26,579.50 | $31,193.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,158.00 / $11,247.00 / $18,564.03
| Facility | | $3,158.00 | $11,247.00 | $18,564.03 |