- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,395.65 / $14,985.90 / $26,390.10
| Facility | | $9,395.65 | $14,985.90 | $26,390.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,192.00 / $12,905.44 / $18,644.45
| Facility | | $6,192.00 | $12,905.44 | $18,644.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,687.79 / $11,652.30 / $19,520.33
| Facility | | $8,687.79 | $11,652.30 | $19,520.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,211.13 / $10,597.19 / $12,936.69
| Facility | | $7,211.13 | $10,597.19 | $12,936.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,661.59 / $11,168.09 / $17,773.98
| Facility | | $5,661.59 | $11,168.09 | $17,773.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,135.70 / $12,628.35 / $17,171.02
| Facility | | $9,135.70 | $12,628.35 | $17,171.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.00 / $9,386.58 / $24,452.29
| Facility | | $3,630.00 | $9,386.58 | $24,452.29 |