- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,987.63 / $13,067.30 / $24,777.00
| Facility | | $7,987.63 | $13,067.30 | $24,777.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,671.79 / $11,603.36 / $15,671.21
| Facility | | $7,671.79 | $11,603.36 | $15,671.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,073.27 / $11,175.57 / $16,339.00
| Facility | | $7,073.27 | $11,175.57 | $16,339.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,054.00 / $12,371.00 / $19,893.00
| Facility | | $8,054.00 | $12,371.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $13,703.74 / $18,194.77
| Facility | | $5,274.00 | $13,703.74 | $18,194.77 |