- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,994.02 / $9,014.34 / $18,319.50
| Facility | | $6,994.02 | $9,014.34 | $18,319.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,756.54 / $8,756.54 / $10,047.07
| Facility | | $8,756.54 | $8,756.54 | $10,047.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,005.57 / $8,781.62 / $10,039.67
| Facility | | $7,005.57 | $8,781.62 | $10,039.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,582.72 / $9,882.00 / $12,851.97
| Facility | | $5,582.72 | $9,882.00 | $12,851.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,070.03 / $10,070.03 / $11,554.13
| Facility | | $10,070.03 | $10,070.03 | $11,554.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $7,925.12 / $12,204.88
| Facility | | $1,286.00 | $7,925.12 | $12,204.88 |