- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,386.71 / $9,520.46 / $19,348.09
| Facility | | $7,386.71 | $9,520.46 | $19,348.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,067.53 / $8,067.53 / $11,793.51
| Facility | | $8,067.53 | $8,067.53 | $11,793.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,286.02 / $9,133.18 / $10,441.59
| Facility | | $7,286.02 | $9,133.18 | $10,441.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,896.18 / $10,436.85 / $13,573.57
| Facility | | $5,896.18 | $10,436.85 | $13,573.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,848.15 / $9,892.21 / $13,562.54
| Facility | | $6,848.15 | $9,892.21 | $13,562.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $8,370.10 / $12,890.15
| Facility | | $1,286.00 | $8,370.10 | $12,890.15 |