- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,601.89 / $9,123.84 / $19,366.80
| Facility | | $5,601.89 | $9,123.84 | $19,366.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,028.32 / $7,371.53 / $16,969.23
| Facility | | $6,028.32 | $7,371.53 | $16,969.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $6,989.00 / $12,596.95
| Facility | | $100.00 | $6,989.00 | $12,596.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,588.40 / $10,211.08 / $16,764.97
| Facility | | $6,588.40 | $10,211.08 | $16,764.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,061.03 / $11,705.05 / $13,736.87
| Facility | | $8,061.03 | $11,705.05 | $13,736.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,602.19 / $7,734.42 / $19,190.20
| Facility | | $5,602.19 | $7,734.42 | $19,190.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,184.00 / $8,963.19 / $14,427.58
| Facility | | $5,184.00 | $8,963.19 | $14,427.58 |