- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,430.17 / $9,842.29 / $17,220.30
| Facility | | $7,430.17 | $9,842.29 | $17,220.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,518.66 / $8,079.32 / $14,815.00
| Facility | | $5,518.66 | $8,079.32 | $14,815.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,377.00 / $9,351.57 / $17,033.83
| Facility | | $5,377.00 | $9,351.57 | $17,033.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,127.03 / $10,579.04 / $17,470.00
| Facility | | $7,127.03 | $10,579.04 | $17,470.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,450.77 / $10,768.00 / $15,492.11
| Facility | | $3,450.77 | $10,768.00 | $15,492.11 |