- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,991.37 / $14,915.20 / $20,015.00
| Facility | | $8,991.37 | $14,915.20 | $20,015.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,896.58 / $8,896.58 / $8,896.58
| Facility | | $8,896.58 | $8,896.58 | $8,896.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,967.74 / $11,904.87 / $18,719.75
| Facility | | $6,967.74 | $11,904.87 | $18,719.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,383.13 / $12,009.00 / $27,541.44
| Facility | | $7,383.13 | $12,009.00 | $27,541.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,713.73 / $11,829.67 / $16,758.16
| Facility | | $8,713.73 | $11,829.67 | $16,758.16 |