- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,955.46 / $13,134.80 / $21,806.90
| Facility | | $8,955.46 | $13,134.80 | $21,806.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,952.00 / $12,206.92 / $12,343.51
| Facility | | $11,952.00 | $12,206.92 | $12,343.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,919.65 / $12,123.73 / $20,490.90
| Facility | | $7,919.65 | $12,123.73 | $20,490.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,259.90 / $13,378.07 / $20,144.40
| Facility | | $10,259.90 | $13,378.07 | $20,144.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,038.13 / $14,064.99 / $35,413.57
| Facility | | $7,038.13 | $14,064.99 | $35,413.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,038.13 / $13,289.11 / $18,873.43
| Facility | | $7,038.13 | $13,289.11 | $18,873.43 |