- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,722.82 / $16,596.50 / $26,976.30
| Facility | | $9,722.82 | $16,596.50 | $26,976.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,231.00 / $13,477.00 / $17,479.31
| Facility | | $11,231.00 | $13,477.00 | $17,479.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,306.20 / $13,186.73 / $20,803.34
| Facility | | $8,306.20 | $13,186.73 | $20,803.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,899.94 / $12,219.60 / $23,398.20
| Facility | | $6,899.94 | $12,219.60 | $23,398.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,289.00 / $13,965.51 / $18,944.77
| Facility | | $6,289.00 | $13,965.51 | $18,944.77 |