- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,553.31 / $11,330.00 / $19,823.30
| Facility | | $8,553.31 | $11,330.00 | $19,823.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,556.37 / $12,556.37 / $13,953.71
| Facility | | $12,556.37 | $12,556.37 | $13,953.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,769.66 / $10,709.18 / $18,406.65
| Facility | | $5,769.66 | $10,709.18 | $18,406.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,946.94 / $12,178.15 / $17,700.16
| Facility | | $7,946.94 | $12,178.15 | $17,700.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $11,676.15 / $17,604.59
| Facility | | $3,496.00 | $11,676.15 | $17,604.59 |