- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,731.37 / $14,904.10 / $24,225.40
| Facility | | $8,731.37 | $14,904.10 | $24,225.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,720.80 / $11,339.00 / $12,013.68
| Facility | | $5,720.80 | $11,339.00 | $12,013.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,532.15 / $11,842.06 / $18,681.99
| Facility | | $7,532.15 | $11,842.06 | $18,681.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,843.51 / $12,363.66 / $23,509.95
| Facility | | $6,843.51 | $12,363.66 | $23,509.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,192.05 / $12,541.42 / $17,032.25
| Facility | | $6,192.05 | $12,541.42 | $17,032.25 |