- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,166.80 / $12,642.10 / $14,306.50
| Facility | | $8,166.80 | $12,642.10 | $14,306.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,020.66 / $12,131.01 / $16,383.85
| Facility | | $8,020.66 | $12,131.01 | $16,383.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,541.45 / $11,637.26 / $16,339.00
| Facility | | $7,541.45 | $11,637.26 | $16,339.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,207.00 / $12,994.00 / $19,893.00
| Facility | | $8,207.00 | $12,994.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $14,720.24 / $19,445.78
| Facility | | $5,274.00 | $14,720.24 | $19,445.78 |