- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,668.34 / $9,883.44 / $20,085.80
| Facility | | $7,668.34 | $9,883.44 | $20,085.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,637.10 / $9,994.96 / $12,156.89
| Facility | | $7,637.10 | $9,994.96 | $12,156.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,679.36 / $9,626.24 / $11,005.28
| Facility | | $7,679.36 | $9,626.24 | $11,005.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,120.97 / $10,834.76 / $14,091.08
| Facility | | $6,120.97 | $10,834.76 | $14,091.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,819.40 / $11,506.23 / $13,980.42
| Facility | | $8,819.40 | $11,506.23 | $13,980.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $8,689.20 / $13,381.60
| Facility | | $1,286.00 | $8,689.20 | $13,381.60 |