- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,288.79 / $12,090.90 / $16,225.00
| Facility | | $7,288.79 | $12,090.90 | $16,225.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,586.81 / $8,903.15 / $14,134.59
| Facility | | $8,586.81 | $8,903.15 | $14,134.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,772.78 / $9,938.02 / $15,808.81
| Facility | | $5,772.78 | $9,938.02 | $15,808.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,985.08 / $9,735.00 / $22,326.25
| Facility | | $5,985.08 | $9,735.00 | $22,326.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,063.72 / $9,589.62 / $13,584.87
| Facility | | $7,063.72 | $9,589.62 | $13,584.87 |