- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,771.12 / $8,969.29 / $15,692.90
| Facility | | $6,771.12 | $8,969.29 | $15,692.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,093.28 / $8,440.00 / $14,182.10
| Facility | | $7,093.28 | $8,440.00 | $14,182.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,003.82 / $9,033.65 / $15,209.75
| Facility | | $5,003.82 | $9,033.65 | $15,209.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,494.87 / $9,773.71 / $15,957.23
| Facility | | $6,494.87 | $9,773.71 | $15,957.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,300.00 / $9,922.03 / $14,117.97
| Facility | | $3,300.00 | $9,922.03 | $14,117.97 |