- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,192.93 / $11,411.00 / $22,621.00
| Facility | | $7,192.93 | $11,411.00 | $22,621.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,646.89 / $9,957.43 / $16,868.09
| Facility | | $6,646.89 | $9,957.43 | $16,868.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,825.77 / $12,158.59 / $17,482.57
| Facility | | $9,825.77 | $12,158.59 | $17,482.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,163.39 / $11,946.52 / $29,722.27
| Facility | | $8,163.39 | $11,946.52 | $29,722.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,331.07 / $11,020.03 / $16,170.41
| Facility | | $7,331.07 | $11,020.03 | $16,170.41 |