- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,040.94 / $7,785.95 / $15,823.10
| Facility | | $6,040.94 | $7,785.95 | $15,823.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,663.18 / $9,110.43 / $10,707.05
| Facility | | $8,663.18 | $9,110.43 | $10,707.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,027.90 / $7,556.10 / $8,638.58
| Facility | | $6,027.90 | $7,556.10 | $8,638.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,821.96 / $8,535.37 / $11,100.62
| Facility | | $4,821.96 | $8,535.37 | $11,100.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,962.66 / $10,269.35 / $12,313.11
| Facility | | $9,962.66 | $10,269.35 | $12,313.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $6,845.16 / $10,541.72
| Facility | | $1,286.00 | $6,845.16 | $10,541.72 |