- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,275.98 / $8,088.89 / $16,438.80
| Facility | | $6,275.98 | $8,088.89 | $16,438.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,055.05 / $8,961.56 / $9,469.26
| Facility | | $7,055.05 | $8,961.56 | $9,469.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,395.68 / $8,017.12 / $9,165.64
| Facility | | $6,395.68 | $8,017.12 | $9,165.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,009.58 / $8,867.48 / $11,532.53
| Facility | | $5,009.58 | $8,867.48 | $11,532.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,113.31 / $10,305.79 / $10,638.56
| Facility | | $8,113.31 | $10,305.79 | $10,638.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $7,111.50 / $10,951.88
| Facility | | $1,286.00 | $7,111.50 | $10,951.88 |