- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,089.09 / $13,957.10 / $23,172.20
| Facility | | $9,089.09 | $13,957.10 | $23,172.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,624.81 / $12,385.65 / $20,532.24
| Facility | | $6,624.81 | $12,385.65 | $20,532.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,018.29 / $14,886.90 / $19,654.00
| Facility | | $11,018.29 | $14,886.90 | $19,654.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,478.75 / $14,945.53 / $36,178.62
| Facility | | $7,478.75 | $14,945.53 | $36,178.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,478.75 / $14,269.46 / $20,055.02
| Facility | | $7,478.75 | $14,269.46 | $20,055.02 |