- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,892.29 / $11,461.00 / $23,291.70
| Facility | | $8,892.29 | $11,461.00 | $23,291.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,805.52 / $9,805.52 / $9,805.52
| Facility | | $9,805.52 | $9,805.52 | $9,805.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,429.12 / $10,566.08 / $12,079.76
| Facility | | $8,429.12 | $10,566.08 | $12,079.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,097.95 / $12,564.11 / $16,340.17
| Facility | | $7,097.95 | $12,564.11 | $16,340.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,276.35 / $11,276.35 / $16,163.57
| Facility | | $11,276.35 | $11,276.35 | $16,163.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $10,076.11 / $15,517.45
| Facility | | $1,286.00 | $10,076.11 | $15,517.45 |