- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,702.89 / $10,375.90 / $11,742.00
| Facility | | $6,702.89 | $10,375.90 | $11,742.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,257.36 / $9,464.08 / $12,781.95
| Facility | | $6,257.36 | $9,464.08 | $12,781.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,189.63 / $9,551.26 / $14,583.22
| Facility | | $6,189.63 | $9,551.26 | $14,583.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,345.00 / $9,746.00 / $19,082.00
| Facility | | $6,345.00 | $9,746.00 | $19,082.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $10,411.00 / $15,960.09
| Facility | | $5,274.00 | $10,411.00 | $15,960.09 |