- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,027.38 / $11,131.00 / $18,480.00
| Facility | | $8,027.38 | $11,131.00 | $18,480.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,391.64 / $9,784.59 / $16,537.40
| Facility | | $6,391.64 | $9,784.59 | $16,537.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,694.62 / $11,337.08 / $17,071.13
| Facility | | $8,694.62 | $11,337.08 | $17,071.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,964.38 / $11,919.21 / $28,580.90
| Facility | | $5,964.38 | $11,919.21 | $28,580.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,964.38 / $11,099.46 / $15,789.85
| Facility | | $5,964.38 | $11,099.46 | $15,789.85 |