- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,926.50 / $10,977.00 / $18,224.40
| Facility | | $6,926.50 | $10,977.00 | $18,224.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,570.79 / $8,071.97 / $36,039.68
| Facility | | $6,570.79 | $8,071.97 | $36,039.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,299.83 / $9,437.53 / $15,987.37
| Facility | | $6,299.83 | $9,437.53 | $15,987.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,315.00 / $11,708.23 / $16,835.00
| Facility | | $9,315.00 | $11,708.23 | $16,835.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,881.88 / $11,754.34 / $28,170.38
| Facility | | $5,881.88 | $11,754.34 | $28,170.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,881.88 / $11,105.92 / $15,772.84
| Facility | | $5,881.88 | $11,105.92 | $15,772.84 |