- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,686.78 / $10,377.00 / $16,612.09
| Facility | | $6,686.78 | $10,377.00 | $16,612.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,496.18 / $6,719.93 / $10,512.23
| Facility | | $6,496.18 | $6,719.93 | $10,512.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,219.18 / $8,270.54 / $11,647.67
| Facility | | $4,219.18 | $8,270.54 | $11,647.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,179.04 / $8,278.10 / $14,504.33
| Facility | | $6,179.04 | $8,278.10 | $14,504.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,067.32 / $9,375.03 / $12,562.81
| Facility | | $6,067.32 | $9,375.03 | $12,562.81 |