- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,591.62 / $10,446.29 / $17,343.30
| Facility | | $6,591.62 | $10,446.29 | $17,343.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,292.88 / $9,633.40 / $16,302.09
| Facility | | $6,292.88 | $9,633.40 | $16,302.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,844.00 / $11,418.90 / $19,943.22
| Facility | | $8,844.00 | $11,418.90 | $19,943.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,597.50 / $11,186.04 / $28,139.28
| Facility | | $5,597.50 | $11,186.04 | $28,139.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,597.50 / $10,680.03 / $15,010.26
| Facility | | $5,597.50 | $10,680.03 | $15,010.26 |