- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,076.25 / $13,478.80 / $16,275.40
| Facility | | $7,076.25 | $13,478.80 | $16,275.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $12,171.15 / $20,544.84
| Facility | | $6,916.00 | $12,171.15 | $20,544.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,094.40 / $11,857.86 / $14,547.68
| Facility | | $10,094.40 | $11,857.86 | $14,547.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,445.79 / $9,456.29 / $12,350.96
| Facility | | $6,445.79 | $9,456.29 | $12,350.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,988.00 / $12,043.06 / $18,225.71
| Facility | | $7,988.00 | $12,043.06 | $18,225.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,791.04 / $10,695.02 / $13,651.57
| Facility | | $7,791.04 | $10,695.02 | $13,651.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $11,892.06 / $15,986.66
| Facility | | $3,775.00 | $11,892.06 | $15,986.66 |