- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,549.15 / $10,970.00 / $18,212.80
| Facility | | $8,549.15 | $10,970.00 | $18,212.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,347.13 / $9,716.45 / $16,107.39
| Facility | | $6,347.13 | $9,716.45 | $16,107.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,520.68 / $12,222.74 / $18,347.00
| Facility | | $9,520.68 | $12,222.74 | $18,347.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,856.00 / $11,817.38 / $28,381.86
| Facility | | $7,856.00 | $11,817.38 | $28,381.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,878.13 / $11,817.38 / $20,324.21
| Facility | | $5,878.13 | $11,817.38 | $20,324.21 |