- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,151.00 / $10,529.10 / $17,480.80
| Facility | | $8,151.00 | $10,529.10 | $17,480.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,975.86 / $10,450.25 / $17,702.95
| Facility | | $6,975.86 | $10,450.25 | $17,702.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,075.75 / $11,390.00 / $16,801.00
| Facility | | $9,075.75 | $11,390.00 | $16,801.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,641.88 / $11,274.72 / $31,193.30
| Facility | | $5,641.88 | $11,274.72 | $31,193.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,210.77 / $10,652.76 / $15,129.25
| Facility | | $7,210.77 | $10,652.76 | $15,129.25 |