- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,613.00 / $10,197.70 / $14,877.00
| Facility | | $6,613.00 | $10,197.70 | $14,877.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,924.76 / $6,924.76 / $8,431.95
| Facility | | $6,924.76 | $6,924.76 | $8,431.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,631.86 / $8,748.08 / $13,250.49
| Facility | | $5,631.86 | $8,748.08 | $13,250.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,761.42 / $8,319.00 / $13,815.40
| Facility | | $5,761.42 | $8,319.00 | $13,815.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,341.54 / $8,070.00 / $13,074.15
| Facility | | $6,341.54 | $8,070.00 | $13,074.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,550.48 / $10,403.00 / $15,007.68
| Facility | | $5,550.48 | $10,403.00 | $15,007.68 |