- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,034.23 / $10,272.10 / $13,501.00
| Facility | | $7,034.23 | $10,272.10 | $13,501.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,659.17 / $15,262.38 / $25,814.25
| Facility | | $5,659.17 | $15,262.38 | $25,814.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,403.85 / $10,317.71 / $17,269.53
| Facility | | $7,403.85 | $10,317.71 | $17,269.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,848.10 / $11,514.71 / $16,812.41
| Facility | | $8,848.10 | $11,514.71 | $16,812.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,848.10 / $10,704.46 / $16,812.41
| Facility | | $8,848.10 | $10,704.46 | $16,812.41 |