- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,734.79 / $11,973.30 / $13,549.70
| Facility | | $7,734.79 | $11,973.30 | $13,549.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,494.57 / $11,335.31 / $15,309.20
| Facility | | $7,494.57 | $11,335.31 | $15,309.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,142.52 / $11,021.66 / $15,974.00
| Facility | | $7,142.52 | $11,021.66 | $15,974.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,576.00 / $11,953.00 / $19,242.00
| Facility | | $7,576.00 | $11,953.00 | $19,242.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $11,200.00 / $18,372.89
| Facility | | $5,274.00 | $11,200.00 | $18,372.89 |