- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,485.62 / $9,917.59 / $26,350.10
| Facility | | $7,485.62 | $9,917.59 | $26,350.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,695.44 / $8,718.82 / $14,453.58
| Facility | | $5,695.44 | $8,718.82 | $14,453.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,539.87 / $10,853.00 / $18,264.00
| Facility | | $8,539.87 | $10,853.00 | $18,264.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,308.75 / $10,652.33 / $25,467.79
| Facility | | $5,308.75 | $10,652.33 | $25,467.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,308.75 / $10,129.10 / $14,235.94
| Facility | | $5,308.75 | $10,129.10 | $14,235.94 |