- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,194.64 / $11,842.50 / $19,661.30
| Facility | | $8,194.64 | $11,842.50 | $19,661.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,803.38 / $10,414.89 / $17,602.70
| Facility | | $6,803.38 | $10,414.89 | $17,602.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,207.83 / $13,194.84 / $22,214.00
| Facility | | $10,207.83 | $13,194.84 | $22,214.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,345.63 / $12,133.85 / $30,422.02
| Facility | | $6,345.63 | $12,133.85 | $30,422.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,345.63 / $12,107.45 / $17,016.43
| Facility | | $6,345.63 | $12,107.45 | $17,016.43 |