- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,457.23 / $11,543.60 / $13,063.50
| Facility | | $7,457.23 | $11,543.60 | $13,063.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,402.05 / $11,195.39 / $15,120.22
| Facility | | $7,402.05 | $11,195.39 | $15,120.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,881.55 / $10,626.15 / $15,866.00
| Facility | | $6,881.55 | $10,626.15 | $15,866.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,059.00 / $11,854.00 / $19,338.00
| Facility | | $7,059.00 | $11,854.00 | $19,338.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $13,341.32 / $17,756.23
| Facility | | $5,274.00 | $13,341.32 | $17,756.23 |