- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,631.06 / $11,433.00 / $20,003.50
| Facility | | $8,631.06 | $11,433.00 | $20,003.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,574.22 / $11,462.76 / $18,651.57
| Facility | | $6,574.22 | $11,462.76 | $18,651.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,843.91 / $10,601.66 / $20,317.73
| Facility | | $5,843.91 | $10,601.66 | $20,317.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,278.92 / $12,288.85 / $17,859.59
| Facility | | $8,278.92 | $12,288.85 | $17,859.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,300.00 / $11,782.28 / $17,995.98
| Facility | | $3,300.00 | $11,782.28 | $17,995.98 |