- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,633.47 / $13,982.70 / $19,798.00
| Facility | | $7,633.47 | $13,982.70 | $19,798.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,549.49 / $11,967.74 / $18,687.62
| Facility | | $7,549.49 | $11,967.74 | $18,687.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,936.50 / $12,578.15 / $22,378.53
| Facility | | $7,936.50 | $12,578.15 | $22,378.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,264.00 / $11,867.47 / $26,462.65
| Facility | | $5,264.00 | $11,867.47 | $26,462.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $11,608.94 / $23,516.09
| Facility | | $3,308.00 | $11,608.94 | $23,516.09 |