- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,540.21 / $9,988.06 / $17,475.30
| Facility | | $7,540.21 | $9,988.06 | $17,475.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,972.37 / $7,646.85 / $19,969.71
| Facility | | $5,972.37 | $7,646.85 | $19,969.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,425.40 / $9,997.94 / $17,308.40
| Facility | | $5,425.40 | $9,997.94 | $17,308.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,232.58 / $10,735.71 / $17,470.00
| Facility | | $7,232.58 | $10,735.71 | $17,470.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $10,768.00 / $15,721.55
| Facility | | $3,496.00 | $10,768.00 | $15,721.55 |