- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,721.36 / $11,958.00 / $13,526.20
| Facility | | $7,721.36 | $11,958.00 | $13,526.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,737.55 / $11,702.82 / $15,805.54
| Facility | | $7,737.55 | $11,702.82 | $15,805.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,130.12 / $11,002.53 / $16,339.00
| Facility | | $7,130.12 | $11,002.53 | $16,339.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,229.00 / $12,816.00 / $19,893.00
| Facility | | $8,229.00 | $12,816.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $13,813.87 / $18,385.15
| Facility | | $5,274.00 | $13,813.87 | $18,385.15 |