- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,467.56 / $15,705.10 / $21,075.00
| Facility | | $9,467.56 | $15,705.10 | $21,075.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,714.49 / $8,714.49 / $13,243.55
| Facility | | $8,714.49 | $8,714.49 | $13,243.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,946.67 / $13,606.42 / $21,462.89
| Facility | | $7,946.67 | $13,606.42 | $21,462.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,774.15 / $12,645.00 / $29,000.04
| Facility | | $7,774.15 | $12,645.00 | $29,000.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,230.01 / $12,456.17 / $17,645.68
| Facility | | $9,230.01 | $12,456.17 | $17,645.68 |