- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,941.37 / $8,731.71 / $13,481.00
| Facility | | $5,941.37 | $8,731.71 | $13,481.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,898.54 / $11,898.54 / $13,624.86
| Facility | | $11,898.54 | $11,898.54 | $13,624.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,553.02 / $19,267.65 / $24,702.11
| Facility | | $13,553.02 | $19,267.65 | $24,702.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,686.80 / $12,928.30 / $16,351.96
| Facility | | $6,686.80 | $12,928.30 | $16,351.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,941.37 / $8,931.03 / $14,281.10
| Facility | | $5,941.37 | $8,931.03 | $14,281.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,948.36 / $11,881.78 / $18,051.88
| Facility | | $6,948.36 | $11,881.78 | $18,051.88 |