- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,218.54 / $15,735.70 / $25,577.10
| Facility | | $9,218.54 | $15,735.70 | $25,577.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,339.00 / $11,339.00 / $14,587.35
| Facility | | $11,339.00 | $11,339.00 | $14,587.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,952.42 / $12,502.80 / $19,724.38
| Facility | | $7,952.42 | $12,502.80 | $19,724.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,029.43 / $18,248.82 / $37,420.58
| Facility | | $8,029.43 | $18,248.82 | $37,420.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,040.00 / $13,058.48 / $18,123.02
| Facility | | $6,040.00 | $13,058.48 | $18,123.02 |