- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,978.00 / $11,476.10 / $15,770.80
| Facility | | $8,978.00 | $11,476.10 | $15,770.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,017.85 / $10,783.29 / $11,443.34
| Facility | | $10,017.85 | $10,783.29 | $11,443.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,708.22 / $10,775.02 / $16,101.03
| Facility | | $6,708.22 | $10,775.02 | $16,101.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,564.00 / $9,535.23 / $15,895.53
| Facility | | $6,564.00 | $9,535.23 | $15,895.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,564.00 / $9,535.23 / $14,490.81
| Facility | | $6,564.00 | $9,535.23 | $14,490.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,774.30 / $12,033.14 / $17,529.68
| Facility | | $6,774.30 | $12,033.14 | $17,529.68 |