- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,747.10 / $11,992.40 / $13,571.30
| Facility | | $7,747.10 | $11,992.40 | $13,571.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,259.18 / $12,491.77 / $16,871.08
| Facility | | $8,259.18 | $12,491.77 | $16,871.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,153.89 / $11,039.21 / $17,092.00
| Facility | | $7,153.89 | $11,039.21 | $17,092.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,334.00 / $13,151.80 / $19,082.00
| Facility | | $8,334.00 | $13,151.80 | $19,082.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $11,113.00 / $18,402.14
| Facility | | $5,274.00 | $11,113.00 | $18,402.14 |