- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,369.11 / $11,086.00 / $19,396.40
| Facility | | $8,369.11 | $11,086.00 | $19,396.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,644.04 / $10,898.60 / $15,863.13
| Facility | | $8,644.04 | $10,898.60 | $15,863.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,843.91 / $9,967.60 / $19,102.58
| Facility | | $5,843.91 | $9,967.60 | $19,102.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,027.66 / $11,915.89 / $17,512.00
| Facility | | $8,027.66 | $11,915.89 | $17,512.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $11,424.70 / $17,449.82
| Facility | | $3,496.00 | $11,424.70 | $17,449.82 |