- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,568.73 / $9,755.06 / $19,824.90
| Facility | | $7,568.73 | $9,755.06 | $19,824.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,568.01 / $8,918.89 / $11,963.26
| Facility | | $7,568.01 | $8,918.89 | $11,963.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,320.10 / $9,175.90 / $10,490.43
| Facility | | $7,320.10 | $9,175.90 | $10,490.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,041.46 / $10,694.03 / $13,908.04
| Facility | | $6,041.46 | $10,694.03 | $13,908.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,703.20 / $10,256.71 / $13,757.75
| Facility | | $8,703.20 | $10,256.71 | $13,757.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $8,576.34 / $13,207.78
| Facility | | $1,286.00 | $8,576.34 | $13,207.78 |