- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,010.85 / $8,833.84 / $13,638.70
| Facility | | $6,010.85 | $8,833.84 | $13,638.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,595.89 / $12,670.45 / $22,544.22
| Facility | | $12,595.89 | $12,670.45 | $22,544.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,822.16 / $16,806.96 / $21,547.39
| Facility | | $11,822.16 | $16,806.96 | $21,547.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,765.00 / $13,079.50 / $16,543.20
| Facility | | $6,765.00 | $13,079.50 | $16,543.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,010.85 / $9,035.48 / $14,448.10
| Facility | | $6,010.85 | $9,035.48 | $14,448.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,029.62 / $12,020.74 / $18,263.00
| Facility | | $7,029.62 | $12,020.74 | $18,263.00 |