- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,138.00 / $8,951.25 / $14,530.70
| Facility | | $6,138.00 | $8,951.25 | $14,530.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,513.61 / $13,324.09 / $15,213.52
| Facility | | $10,513.61 | $13,324.09 | $15,213.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,763.91 / $18,145.80 / $23,263.84
| Facility | | $12,763.91 | $18,145.80 | $23,263.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,207.45 / $13,934.94 / $17,625.16
| Facility | | $7,207.45 | $13,934.94 | $17,625.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,403.98 / $9,626.43 / $15,393.10
| Facility | | $6,403.98 | $9,626.43 | $15,393.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,489.38 / $12,806.94 / $19,457.46
| Facility | | $7,489.38 | $12,806.94 | $19,457.46 |