- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,141.63 / $12,916.00 / $26,396.00
| Facility | | $8,141.63 | $12,916.00 | $26,396.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,148.34 / $10,708.64 / $18,140.66
| Facility | | $7,148.34 | $10,708.64 | $18,140.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,579.70 / $13,762.23 / $19,705.84
| Facility | | $10,579.70 | $13,762.23 | $19,705.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,787.00 / $13,646.08 / $24,334.00
| Facility | | $8,787.00 | $13,646.08 | $24,334.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,913.75 / $13,191.44 / $18,539.91
| Facility | | $6,913.75 | $13,191.44 | $18,539.91 |