- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,149.56 / $14,928.00 / $21,136.50
| Facility | | $8,149.56 | $14,928.00 | $21,136.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,171.66 / $12,918.39 / $15,610.98
| Facility | | $9,171.66 | $12,918.39 | $15,610.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,959.37 / $15,956.71 / $26,409.03
| Facility | | $9,959.37 | $15,956.71 | $26,409.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,473.08 / $12,845.70 / $23,891.52
| Facility | | $8,473.08 | $12,845.70 | $23,891.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,391.96 / $12,788.02 / $28,251.76
| Facility | | $5,391.96 | $12,788.02 | $28,251.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $12,393.81 / $25,105.99
| Facility | | $3,308.00 | $12,393.81 | $25,105.99 |