- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,992.93 / $7,724.07 / $15,697.40
| Facility | | $5,992.93 | $7,724.07 | $15,697.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,255.10 / $8,499.50 / $9,796.46
| Facility | | $6,255.10 | $8,499.50 | $9,796.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,981.04 / $7,497.36 / $8,571.42
| Facility | | $5,981.04 | $7,497.36 | $8,571.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,783.64 / $8,467.54 / $11,012.40
| Facility | | $4,783.64 | $8,467.54 | $11,012.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,193.37 / $10,806.53 / $11,265.94
| Facility | | $7,193.37 | $10,806.53 | $11,265.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,857.00 / $8,785.33 / $11,909.75
| Facility | | $1,857.00 | $8,785.33 | $11,909.75 |