- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,511.07 / $10,464.00 / $17,354.90
| Facility | | $7,511.07 | $10,464.00 | $17,354.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,078.00 / $9,500.29 / $11,549.86
| Facility | | $5,078.00 | $9,500.29 | $11,549.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,379.12 / $9,556.29 / $16,188.58
| Facility | | $6,379.12 | $9,556.29 | $16,188.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,010.39 / $11,149.62 / $16,031.80
| Facility | | $9,010.39 | $11,149.62 | $16,031.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,601.25 / $11,239.24 / $17,943.72
| Facility | | $5,601.25 | $11,239.24 | $17,943.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,601.25 / $10,687.19 / $15,020.31
| Facility | | $5,601.25 | $10,687.19 | $15,020.31 |