- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,498.20 / $14,866.80 / $26,254.00
| Facility | | $6,498.20 | $14,866.80 | $26,254.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,530.54 / $11,257.87 / $15,440.03
| Facility | | $9,530.54 | $11,257.87 | $15,440.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $9,690.29 / $20,905.66
| Facility | | $1,474.01 | $9,690.29 | $20,905.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,755.39 / $15,535.16 / $22,007.42
| Facility | | $10,755.39 | $15,535.16 | $22,007.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,401.39 / $13,029.76 / $27,364.11
| Facility | | $9,401.39 | $13,029.76 | $27,364.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,826.93 / $13,029.76 / $27,717.43
| Facility | | $8,826.93 | $13,029.76 | $27,717.43 |