- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,973.21 / $10,183.00 / $13,383.90
| Facility | | $6,973.21 | $10,183.00 | $13,383.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.30 / $10,842.57 / $18,338.75
| Facility | | $3,981.30 | $10,842.57 | $18,338.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,339.62 / $10,228.20 / $17,119.71
| Facility | | $7,339.62 | $10,228.20 | $17,119.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,771.35 / $11,414.82 / $16,666.56
| Facility | | $8,771.35 | $11,414.82 | $16,666.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,771.35 / $10,611.59 / $16,666.56
| Facility | | $8,771.35 | $10,611.59 | $16,666.56 |