- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,141.06 / $12,602.20 / $14,261.40
| Facility | | $8,141.06 | $12,602.20 | $14,261.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,085.30 / $12,228.79 / $16,515.90
| Facility | | $8,085.30 | $12,228.79 | $16,515.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,517.68 / $11,600.58 / $16,339.00
| Facility | | $7,517.68 | $11,600.58 | $16,339.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,369.00 / $12,964.00 / $19,893.00
| Facility | | $8,369.00 | $12,964.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,008.00 / $11,757.27 / $19,337.93
| Facility | | $4,008.00 | $11,757.27 | $19,337.93 |