- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,338.59 / $11,360.00 / $12,855.70
| Facility | | $7,338.59 | $11,360.00 | $12,855.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,120.97 / $12,282.73 / $16,588.75
| Facility | | $8,120.97 | $12,282.73 | $16,588.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,776.66 / $10,551.52 / $15,866.00
| Facility | | $6,776.66 | $10,551.52 | $15,866.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,774.93 / $13,201.00 / $19,893.00
| Facility | | $7,774.93 | $13,201.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $13,129.08 / $17,473.75
| Facility | | $5,274.00 | $13,129.08 | $17,473.75 |