- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,611.92 / $11,407.70 / $19,959.09
| Facility | | $8,611.92 | $11,407.70 | $19,959.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,000.00 / $9,044.41 / $13,527.61
| Facility | | $6,000.00 | $9,044.41 | $13,527.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,786.47 / $10,023.79 / $19,393.45
| Facility | | $5,786.47 | $10,023.79 | $19,393.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,260.56 / $11,687.76 / $17,821.43
| Facility | | $8,260.56 | $11,687.76 | $17,821.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $12,993.12 / $18,548.40
| Facility | | $3,496.00 | $12,993.12 | $18,548.40 |