- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,502.08 / $9,314.87 / $15,464.90
| Facility | | $6,502.08 | $9,314.87 | $15,464.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,104.02 / $7,104.02 / $14,940.00
| Facility | | $7,104.02 | $7,104.02 | $14,940.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,586.25 / $8,368.54 / $14,176.48
| Facility | | $5,586.25 | $8,368.54 | $14,176.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,029.12 / $9,935.37 / $14,285.87
| Facility | | $8,029.12 | $9,935.37 | $14,285.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,991.25 / $9,974.51 / $24,979.52
| Facility | | $4,991.25 | $9,974.51 | $24,979.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,354.25 / $9,226.00 / $13,213.64
| Facility | | $6,354.25 | $9,226.00 | $13,213.64 |