- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,073.06 / $10,976.50 / $17,571.80
| Facility | | $7,073.06 | $10,976.50 | $17,571.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,184.00 / $11,207.83 / $13,436.16
| Facility | | $11,184.00 | $11,207.83 | $13,436.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,459.43 / $8,646.96 / $12,310.95
| Facility | | $4,459.43 | $8,646.96 | $12,310.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,535.99 / $8,756.31 / $15,342.21
| Facility | | $6,535.99 | $8,756.31 | $15,342.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,417.82 / $9,916.60 / $13,288.54
| Facility | | $6,417.82 | $9,916.60 | $13,288.54 |