- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,314.70 / $10,716.50 / $21,778.80
| Facility | | $8,314.70 | $10,716.50 | $21,778.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,740.70 / $11,779.19 / $12,951.24
| Facility | | $8,740.70 | $11,779.19 | $12,951.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,338.24 / $10,452.16 / $11,949.52
| Facility | | $8,338.24 | $10,452.16 | $11,949.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,636.92 / $11,748.04 / $15,278.83
| Facility | | $6,636.92 | $11,748.04 | $15,278.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,051.82 / $13,546.07 / $14,893.93
| Facility | | $10,051.82 | $13,546.07 | $14,893.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $9,421.64 / $14,509.55
| Facility | | $1,286.00 | $9,421.64 | $14,509.55 |