- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,838.82 / $13,380.60 / $21,749.00
| Facility | | $7,838.82 | $13,380.60 | $21,749.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,687.00 / $12,931.29 / $14,356.06
| Facility | | $9,687.00 | $12,931.29 | $14,356.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,762.19 / $10,631.52 / $16,772.25
| Facility | | $6,762.19 | $10,631.52 | $16,772.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,714.68 / $13,991.75 / $27,653.30
| Facility | | $6,714.68 | $13,991.75 | $27,653.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,164.00 / $11,259.40 / $15,291.16
| Facility | | $6,164.00 | $11,259.40 | $15,291.16 |