- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,990.51 / $11,212.80 / $16,624.00
| Facility | | $7,990.51 | $11,212.80 | $16,624.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,973.58 / $7,310.89 / $18,653.31
| Facility | | $5,973.58 | $7,310.89 | $18,653.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,504.62 / $10,097.54 / $15,255.56
| Facility | | $6,504.62 | $10,097.54 | $15,255.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,970.68 / $9,623.45 / $17,418.00
| Facility | | $6,970.68 | $9,623.45 | $17,418.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.09 / $102.53 / $172.83
| Facility | | $74.09 | $102.53 | $172.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,677.85 / $10,625.85 / $17,487.66
| Facility | | $7,677.85 | $10,625.85 | $17,487.66 |