- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,527.54 / $10,990.80 / $22,336.30
| Facility | | $8,527.54 | $10,990.80 | $22,336.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,940.79 / $11,872.84 / $13,270.57
| Facility | | $10,940.79 | $11,872.84 | $13,270.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,157.90 / $10,226.10 / $11,691.08
| Facility | | $8,157.90 | $10,226.10 | $11,691.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,806.80 / $12,048.75 / $15,669.92
| Facility | | $6,806.80 | $12,048.75 | $15,669.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,581.91 / $13,653.77 / $15,261.16
| Facility | | $12,581.91 | $13,653.77 | $15,261.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $9,662.79 / $14,880.95
| Facility | | $1,286.00 | $9,662.79 | $14,880.95 |