- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,996.02 / $11,648.10 / $16,354.00
| Facility | | $6,996.02 | $11,648.10 | $16,354.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,072.52 / $11,271.51 / $14,582.42
| Facility | | $8,072.52 | $11,271.51 | $14,582.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,435.61 / $10,195.70 / $15,446.71
| Facility | | $6,435.61 | $10,195.70 | $15,446.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,564.00 / $9,217.78 / $15,780.34
| Facility | | $6,564.00 | $9,217.78 | $15,780.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,416.30 / $10,028.62 / $15,325.76
| Facility | | $6,416.30 | $10,028.62 | $15,325.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,225.60 / $11,984.33 / $16,946.08
| Facility | | $6,225.60 | $11,984.33 | $16,946.08 |