- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,415.83 / $14,582.30 / $16,951.00
| Facility | | $9,415.83 | $14,582.30 | $16,951.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,419.28 / $15,758.85 / $21,283.52
| Facility | | $10,419.28 | $15,758.85 | $21,283.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,467.68 / $13,417.05 / $18,553.18
| Facility | | $8,467.68 | $13,417.05 | $18,553.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,914.00 / $16,320.00 / $19,893.00
| Facility | | $8,914.00 | $16,320.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $16,845.34 / $22,419.80
| Facility | | $5,274.00 | $16,845.34 | $22,419.80 |