- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,395.43 / $11,120.90 / $19,457.40
| Facility | | $8,395.43 | $11,120.90 | $19,457.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,836.52 / $8,658.61 / $11,477.00
| Facility | | $7,836.52 | $8,658.61 | $11,477.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,786.47 / $9,769.54 / $18,982.97
| Facility | | $5,786.47 | $9,769.54 | $18,982.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,052.90 / $11,953.36 / $17,512.00
| Facility | | $8,052.90 | $11,953.36 | $17,512.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $11,460.62 / $17,504.68
| Facility | | $3,496.00 | $11,460.62 | $17,504.68 |