- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,436.53 / $13,059.60 / $14,779.00
| Facility | | $8,436.53 | $13,059.60 | $14,779.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,334.77 / $14,118.57 / $19,068.20
| Facility | | $9,334.77 | $14,118.57 | $19,068.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,790.52 / $12,021.60 / $16,623.55
| Facility | | $7,790.52 | $12,021.60 | $16,623.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,124.00 / $14,098.00 / $19,893.00
| Facility | | $9,124.00 | $14,098.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $15,093.34 / $20,039.77
| Facility | | $5,274.00 | $15,093.34 | $20,039.77 |