- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,095.73 / $10,989.10 / $12,430.20
| Facility | | $7,095.73 | $10,989.10 | $12,430.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,851.24 / $11,874.77 / $16,037.77
| Facility | | $7,851.24 | $11,874.77 | $16,037.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,552.39 / $10,202.33 / $15,437.90
| Facility | | $6,552.39 | $10,202.33 | $15,437.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,432.00 / $12,046.00 / $19,082.00
| Facility | | $7,432.00 | $12,046.00 | $19,082.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $12,347.01 / $16,854.89
| Facility | | $5,274.00 | $12,347.01 | $16,854.89 |