- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,924.81 / $10,177.00 / $15,712.50
| Facility | | $6,924.81 | $10,177.00 | $15,712.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,341.54 / $16,123.70 / $20,671.41
| Facility | | $11,341.54 | $16,123.70 | $20,671.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,793.63 / $15,068.26 / $19,058.62
| Facility | | $7,793.63 | $15,068.26 | $19,058.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,924.81 / $10,409.29 / $16,645.00
| Facility | | $6,924.81 | $10,409.29 | $16,645.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,098.49 / $13,848.52 / $21,039.92
| Facility | | $8,098.49 | $13,848.52 | $21,039.92 |