- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,870.09 / $14,714.00 / $19,745.00
| Facility | | $8,870.09 | $14,714.00 | $19,745.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,933.85 / $10,782.41 / $17,700.49
| Facility | | $8,933.85 | $10,782.41 | $17,700.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,414.80 / $12,695.74 / $20,026.37
| Facility | | $7,414.80 | $12,695.74 | $20,026.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,283.54 / $11,847.00 / $27,169.91
| Facility | | $7,283.54 | $11,847.00 | $27,169.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,647.52 / $11,670.08 / $16,532.09
| Facility | | $8,647.52 | $11,670.08 | $16,532.09 |