- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $11,220.18 / $20,892.96
| Facility | | $8,128.31 | $11,220.18 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $12,589.25 / $15,488.17
| Facility | | $12,589.25 | $12,589.25 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $11,220.18 / $14,454.40
| Facility | | $7,079.46 | $11,220.18 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $12,022.64 / $22,387.21
| Facility | | $7,762.47 | $12,022.64 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $11,220.18 / $15,135.61
| Facility | | $7,244.36 | $11,220.18 | $15,135.61 |