- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,734.16 / $8,427.20 / $13,010.90
| Facility | | $5,734.16 | $8,427.20 | $13,010.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,543.00 / $12,447.04 / $35,928.81
| Facility | | $10,543.00 | $12,447.04 | $35,928.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,204.76 / $13,085.94 / $16,776.84
| Facility | | $9,204.76 | $13,085.94 | $16,776.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,453.60 / $12,477.42 / $15,781.68
| Facility | | $6,453.60 | $12,477.42 | $15,781.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,734.16 / $8,619.56 / $13,783.10
| Facility | | $5,734.16 | $8,619.56 | $13,783.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,706.04 / $11,467.40 / $17,422.32
| Facility | | $6,706.04 | $11,467.40 | $17,422.32 |