- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,857.48 / $8,187.38 / $13,290.70
| Facility | | $5,857.48 | $8,187.38 | $13,290.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,945.81 / $11,713.23 / $19,594.46
| Facility | | $10,945.81 | $11,713.23 | $19,594.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,291.21 / $16,052.14 / $20,579.66
| Facility | | $11,291.21 | $16,052.14 | $20,579.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,592.39 / $12,745.77 / $16,121.09
| Facility | | $6,592.39 | $12,745.77 | $16,121.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,857.48 / $8,804.94 / $14,079.50
| Facility | | $5,857.48 | $8,804.94 | $14,079.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,850.26 / $11,714.03 / $17,797.00
| Facility | | $6,850.26 | $11,714.03 | $17,797.00 |