- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,277.40 / $11,312.80 / $15,858.90
| Facility | | $7,277.40 | $11,312.80 | $15,858.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,875.97 / $9,955.82 / $14,576.34
| Facility | | $6,875.97 | $9,955.82 | $14,576.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,610.21 / $10,472.32 / $15,865.79
| Facility | | $6,610.21 | $10,472.32 | $15,865.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,564.00 / $9,588.53 / $16,415.04
| Facility | | $6,564.00 | $9,588.53 | $16,415.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,150.00 / $10,742.97 / $14,667.85
| Facility | | $7,150.00 | $10,742.97 | $14,667.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,476.00 / $12,339.21 / $17,627.66
| Facility | | $6,476.00 | $12,339.21 | $17,627.66 |