- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,070.50 / $11,785.30 / $15,490.00
| Facility | | $8,070.50 | $11,785.30 | $15,490.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,168.01 / $16,797.81 / $28,411.23
| Facility | | $6,168.01 | $16,797.81 | $28,411.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,198.53 / $11,837.71 / $19,813.65
| Facility | | $8,198.53 | $11,837.71 | $19,813.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,151.59 / $13,211.04 / $19,289.18
| Facility | | $10,151.59 | $13,211.04 | $19,289.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,398.56 / $12,712.77 / $18,324.66
| Facility | | $8,398.56 | $12,712.77 | $18,324.66 |