- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,771.51 / $12,891.00 / $19,902.59
| Facility | | $8,771.51 | $12,891.00 | $19,902.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,336.08 / $11,850.98 / $15,193.56
| Facility | | $8,336.08 | $11,850.98 | $15,193.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,872.03 / $19,086.64 / $24,141.15
| Facility | | $9,872.03 | $19,086.64 | $24,141.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,771.51 / $13,185.30 / $21,083.90
| Facility | | $8,771.51 | $13,185.30 | $21,083.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,544.49 / $17,541.62 / $26,650.82
| Facility | | $11,544.49 | $17,541.62 | $26,650.82 |