- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,978.82 / $11,576.70 / $15,535.00
| Facility | | $6,978.82 | $11,576.70 | $15,535.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,855.30 / $7,791.41 / $14,749.88
| Facility | | $6,855.30 | $7,791.41 | $14,749.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,579.57 / $9,772.70 / $15,367.04
| Facility | | $5,579.57 | $9,772.70 | $15,367.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,730.55 / $9,321.00 / $21,376.78
| Facility | | $5,730.55 | $9,321.00 | $21,376.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,763.32 / $9,181.81 / $13,007.14
| Facility | | $6,763.32 | $9,181.81 | $13,007.14 |