- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,186.11 / $10,843.60 / $18,972.30
| Facility | | $8,186.11 | $10,843.60 | $18,972.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,239.05 / $8,874.85 / $14,308.45
| Facility | | $7,239.05 | $8,874.85 | $14,308.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,843.91 / $10,714.51 / $18,711.12
| Facility | | $5,843.91 | $10,714.51 | $18,711.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,852.12 / $11,816.17 / $20,898.00
| Facility | | $7,852.12 | $11,816.17 | $20,898.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $11,174.88 / $17,068.25
| Facility | | $3,496.00 | $11,174.88 | $17,068.25 |