- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,524.60 / $12,451.30 / $20,672.09
| Facility | | $8,524.60 | $12,451.30 | $20,672.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,976.00 / $10,203.86 / $17,928.00
| Facility | | $5,976.00 | $10,203.86 | $17,928.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,446.02 / $11,154.58 / $18,896.09
| Facility | | $7,446.02 | $11,154.58 | $18,896.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,829.54 / $13,280.77 / $19,096.12
| Facility | | $9,829.54 | $13,280.77 | $19,096.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,787.00 / $12,729.94 / $21,373.49
| Facility | | $8,787.00 | $12,729.94 | $21,373.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,671.88 / $12,381.00 / $17,891.30
| Facility | | $6,671.88 | $12,381.00 | $17,891.30 |