- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,619.24 / $11,421.40 / $18,962.20
| Facility | | $7,619.24 | $11,421.40 | $18,962.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,408.33 / $9,810.14 / $16,580.59
| Facility | | $6,408.33 | $9,810.14 | $16,580.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,921.49 / $11,632.90 / $17,516.56
| Facility | | $8,921.49 | $11,632.90 | $17,516.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,120.00 / $12,230.21 / $28,655.54
| Facility | | $6,120.00 | $12,230.21 | $28,655.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,120.00 / $11,676.96 / $16,411.39
| Facility | | $6,120.00 | $11,676.96 | $16,411.39 |