- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,580.93 / $10,474.29 / $16,865.00
| Facility | | $4,580.93 | $10,474.29 | $16,865.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,013.52 / $9,522.86 / $16,436.78
| Facility | | $8,013.52 | $9,522.86 | $16,436.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,930.56 / $15,012.37
| Facility | | $1,474.01 | $5,930.56 | $15,012.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,582.06 / $10,951.57 / $15,514.21
| Facility | | $7,582.06 | $10,951.57 | $15,514.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,627.55 / $9,185.37 / $19,290.43
| Facility | | $6,627.55 | $9,185.37 | $19,290.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,222.58 / $9,185.37 / $19,539.50
| Facility | | $6,222.58 | $9,185.37 | $19,539.50 |