- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,611.97 / $11,328.10 / $18,807.30
| Facility | | $7,611.97 | $11,328.10 | $18,807.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,228.00 / $8,861.75 / $11,252.52
| Facility | | $3,228.00 | $8,861.75 | $11,252.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,723.39 / $10,072.04 / $17,062.25
| Facility | | $6,723.39 | $10,072.04 | $17,062.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,764.44 / $12,082.70 / $17,373.45
| Facility | | $9,764.44 | $12,082.70 | $17,373.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,070.00 / $11,871.95 / $19,445.37
| Facility | | $6,070.00 | $11,871.95 | $19,445.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,070.00 / $11,296.03 / $16,069.48
| Facility | | $6,070.00 | $11,296.03 | $16,069.48 |