- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,517.49 / $9,957.95 / $17,422.59
| Facility | | $7,517.49 | $9,957.95 | $17,422.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,477.00 / $12,671.40 / $15,934.23
| Facility | | $11,477.00 | $12,671.40 | $15,934.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,377.00 / $10,233.41 / $16,927.81
| Facility | | $5,377.00 | $10,233.41 | $16,927.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,210.78 / $10,703.36 / $17,470.00
| Facility | | $7,210.78 | $10,703.36 | $17,470.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,491.32 / $10,768.00 / $15,674.16
| Facility | | $3,491.32 | $10,768.00 | $15,674.16 |