- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,524.13 / $11,924.10 / $19,796.80
| Facility | | $7,524.13 | $11,924.10 | $19,796.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,091.31 / $10,855.68 / $17,995.93
| Facility | | $7,091.31 | $10,855.68 | $17,995.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,314.18 / $12,144.92 / $18,287.56
| Facility | | $9,314.18 | $12,144.92 | $18,287.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,389.38 / $12,217.51 / $39,000.00
| Facility | | $6,389.38 | $12,217.51 | $39,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,389.38 / $12,190.93 / $17,133.75
| Facility | | $6,389.38 | $12,190.93 | $17,133.75 |