- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,028.04 / $7,769.32 / $15,789.30
| Facility | | $6,028.04 | $7,769.32 | $15,789.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,696.54 / $8,910.02 / $10,720.76
| Facility | | $6,696.54 | $8,910.02 | $10,720.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,071.92 / $7,611.28 / $8,701.66
| Facility | | $6,071.92 | $7,611.28 | $8,701.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,811.66 / $8,517.15 / $11,076.92
| Facility | | $4,811.66 | $8,517.15 | $11,076.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,715.96 / $10,295.09 / $12,328.87
| Facility | | $7,715.96 | $10,295.09 | $12,328.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $6,830.54 / $10,519.21
| Facility | | $1,286.00 | $6,830.54 | $10,519.21 |