- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,044.95 / $11,893.00 / $20,928.30
| Facility | | $7,044.95 | $11,893.00 | $20,928.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,256.00 / $13,587.64 / $19,016.93
| Facility | | $5,256.00 | $13,587.64 | $19,016.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,722.46 / $8,449.33 / $13,892.68
| Facility | | $5,722.46 | $8,449.33 | $13,892.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,408.49 / $10,962.48 / $15,727.52
| Facility | | $6,408.49 | $10,962.48 | $15,727.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $10,364.69 / $14,804.77
| Facility | | $1,787.00 | $10,364.69 | $14,804.77 |