- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,739.81 / $14,497.90 / $19,455.00
| Facility | | $8,739.81 | $14,497.90 | $19,455.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,899.44 / $9,958.43 / $13,348.81
| Facility | | $7,899.44 | $9,958.43 | $13,348.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,838.05 / $12,200.77 / $19,410.75
| Facility | | $6,838.05 | $12,200.77 | $19,410.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,176.56 / $11,673.00 / $26,770.86
| Facility | | $7,176.56 | $11,673.00 | $26,770.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,520.51 / $11,498.68 / $16,289.28
| Facility | | $8,520.51 | $11,498.68 | $16,289.28 |