- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,959.62 / $8,970.00 / $18,229.40
| Facility | | $6,959.62 | $8,970.00 | $18,229.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,132.82 / $9,108.70 / $9,859.59
| Facility | | $7,132.82 | $9,108.70 | $9,859.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,798.25 / $8,521.75 / $9,742.56
| Facility | | $6,798.25 | $8,521.75 | $9,742.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,555.26 / $9,833.40 / $12,788.76
| Facility | | $5,555.26 | $9,833.40 | $12,788.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,202.74 / $10,475.02 / $16,969.03
| Facility | | $8,202.74 | $10,475.02 | $16,969.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,857.00 / $10,202.45 / $13,830.86
| Facility | | $1,857.00 | $10,202.45 | $13,830.86 |