- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,195.11 / $11,133.70 / $16,505.00
| Facility | | $8,195.11 | $11,133.70 | $16,505.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,656.15 / $10,352.59 / $15,541.05
| Facility | | $6,656.15 | $10,352.59 | $15,541.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,109.87 / $9,529.54 / $17,864.00
| Facility | | $7,109.87 | $9,529.54 | $17,864.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.98 / $105.16 / $177.26
| Facility | | $75.98 | $105.16 | $177.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,874.45 / $10,897.93 / $17,935.46
| Facility | | $7,874.45 | $10,897.93 | $17,935.46 |