- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,625.34 / $9,828.03 / $19,973.20
| Facility | | $7,625.34 | $9,828.03 | $19,973.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,331.16 / $8,331.16 / $10,301.35
| Facility | | $8,331.16 | $8,331.16 | $10,301.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,468.49 / $9,361.91 / $10,703.08
| Facility | | $7,468.49 | $9,361.91 | $10,703.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,086.65 / $10,774.01 / $14,012.07
| Facility | | $6,086.65 | $10,774.01 | $14,012.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,580.83 / $9,580.83 / $9,580.83
| Facility | | $9,580.83 | $9,580.83 | $9,580.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $8,640.49 / $13,306.57
| Facility | | $1,286.00 | $8,640.49 | $13,306.57 |