- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,503.75 / $14,293.10 / $17,258.59
| Facility | | $7,503.75 | $14,293.10 | $17,258.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $12,906.45 / $22,154.07
| Facility | | $6,916.00 | $12,906.45 | $22,154.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,123.52 / $12,419.38 / $16,381.82
| Facility | | $11,123.52 | $12,419.38 | $16,381.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,200.82 / $10,334.29 / $13,408.36
| Facility | | $7,200.82 | $10,334.29 | $13,408.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,988.00 / $13,011.08 / $19,786.06
| Facility | | $7,988.00 | $13,011.08 | $19,786.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,458.04 / $11,722.82 / $14,979.08
| Facility | | $8,458.04 | $11,722.82 | $14,979.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $11,768.28 / $16,952.47
| Facility | | $3,775.00 | $11,768.28 | $16,952.47 |