- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,842.32 / $14,365.20 / $20,339.59
| Facility | | $7,842.32 | $14,365.20 | $20,339.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,752.59 / $12,221.60 / $15,151.01
| Facility | | $8,752.59 | $12,221.60 | $15,151.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,604.28 / $13,840.02 / $22,257.70
| Facility | | $8,604.28 | $13,840.02 | $22,257.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,153.64 / $12,922.28 / $22,990.79
| Facility | | $8,153.64 | $12,922.28 | $22,990.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,264.00 / $12,130.35 / $27,186.66
| Facility | | $5,264.00 | $12,130.35 | $27,186.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $11,926.55 / $24,159.48
| Facility | | $3,308.00 | $11,926.55 | $24,159.48 |