- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,945.12 / $12,591.30 / $20,904.50
| Facility | | $7,945.12 | $12,591.30 | $20,904.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,611.55 / $11,402.55 / $19,316.16
| Facility | | $7,611.55 | $11,402.55 | $19,316.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,853.29 / $13,763.63 / $20,354.00
| Facility | | $10,853.29 | $13,763.63 | $20,354.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,746.88 / $12,901.10 / $34,035.83
| Facility | | $6,746.88 | $12,901.10 | $34,035.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,623.04 / $12,901.10 / $21,613.75
| Facility | | $8,623.04 | $12,901.10 | $21,613.75 |