- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,852.80 / $11,452.00 / $18,590.20
| Facility | | $7,852.80 | $11,452.00 | $18,590.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,378.06 / $21,862.21 / $28,028.48
| Facility | | $15,378.06 | $21,862.21 | $28,028.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,221.03 / $17,828.00 / $22,549.20
| Facility | | $9,221.03 | $17,828.00 | $22,549.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,193.09 / $12,315.80 / $19,693.50
| Facility | | $8,193.09 | $12,315.80 | $19,693.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,581.71 / $16,384.87 / $24,893.38
| Facility | | $9,581.71 | $16,384.87 | $24,893.38 |