- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,263.48 / $10,674.80 / $16,480.90
| Facility | | $7,263.48 | $10,674.80 | $16,480.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,748.14 / $14,050.00 / $16,817.21
| Facility | | $12,748.14 | $14,050.00 | $16,817.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,846.52 / $16,841.59 / $21,591.78
| Facility | | $11,846.52 | $16,841.59 | $21,591.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,174.79 / $15,805.19 / $19,990.70
| Facility | | $8,174.79 | $15,805.19 | $19,990.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,263.48 / $10,918.40 / $17,459.00
| Facility | | $7,263.48 | $10,918.40 | $17,459.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,494.56 / $14,525.80 / $22,068.91
| Facility | | $8,494.56 | $14,525.80 | $22,068.91 |