- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,284.27 / $11,966.20 / $24,318.40
| Facility | | $9,284.27 | $11,966.20 | $24,318.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,675.64 / $13,633.64 / $13,955.73
| Facility | | $12,675.64 | $13,633.64 | $13,955.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,678.71 / $12,132.48 / $13,870.56
| Facility | | $9,678.71 | $12,132.48 | $13,870.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,410.83 / $13,117.95 / $17,060.46
| Facility | | $7,410.83 | $13,117.95 | $17,060.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,774.39 / $14,576.99 / $15,487.95
| Facility | | $11,774.39 | $14,576.99 | $15,487.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $10,520.27 / $16,201.48
| Facility | | $1,286.00 | $10,520.27 | $16,201.48 |