- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,027.58 / $8,169.70 / $29,502.00
| Facility | | $6,027.58 | $8,169.70 | $29,502.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,711.85 / $12,672.00 / $15,174.56
| Facility | | $6,711.85 | $12,672.00 | $15,174.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,887.27 / $7,321.43 / $12,402.65
| Facility | | $4,887.27 | $7,321.43 | $12,402.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,972.00 / $8,704.96 / $12,516.68
| Facility | | $6,972.00 | $8,704.96 | $12,516.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,373.13 / $8,787.00 / $21,853.97
| Facility | | $4,373.13 | $8,787.00 | $21,853.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,373.13 / $8,553.12 / $11,726.97
| Facility | | $4,373.13 | $8,553.12 | $11,726.97 |