- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,932.61 / $12,571.50 / $20,871.59
| Facility | | $7,932.61 | $12,571.50 | $20,871.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,967.51 / $10,437.75 / $17,681.77
| Facility | | $6,967.51 | $10,437.75 | $17,681.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,506.00 / $13,408.91 / $19,199.93
| Facility | | $10,506.00 | $13,408.91 | $19,199.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,736.25 / $13,461.72 / $31,155.98
| Facility | | $6,736.25 | $13,461.72 | $31,155.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,736.25 / $12,852.77 / $18,063.93
| Facility | | $6,736.25 | $12,852.77 | $18,063.93 |