- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,976.57 / $11,573.00 / $15,530.00
| Facility | | $6,976.57 | $11,573.00 | $15,530.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,356.08 / $9,415.29 / $14,814.13
| Facility | | $6,356.08 | $9,415.29 | $14,814.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,683.88 / $9,955.42 / $15,654.34
| Facility | | $5,683.88 | $9,955.42 | $15,654.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,728.71 / $9,318.00 / $21,369.90
| Facility | | $5,728.71 | $9,318.00 | $21,369.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,801.52 / $9,178.85 / $13,002.96
| Facility | | $6,801.52 | $9,178.85 | $13,002.96 |