- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,088.45 / $9,429.15 / $10,665.70
| Facility | | $6,088.45 | $9,429.15 | $10,665.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,099.09 / $9,224.69 / $12,458.64
| Facility | | $6,099.09 | $9,224.69 | $12,458.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,622.24 / $8,675.70 / $13,246.40
| Facility | | $5,622.24 | $8,675.70 | $13,246.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,528.00 / $10,124.00 / $19,082.00
| Facility | | $6,528.00 | $10,124.00 | $19,082.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $10,974.11 / $14,497.06
| Facility | | $5,274.00 | $10,974.11 | $14,497.06 |