- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,712.38 / $12,295.40 / $17,409.00
| Facility | | $6,712.38 | $12,295.40 | $17,409.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,345.92 / $10,172.65 / $16,008.04
| Facility | | $6,345.92 | $10,172.65 | $16,008.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,873.10 / $11,060.40 / $19,678.21
| Facility | | $6,873.10 | $11,060.40 | $19,678.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,181.26 / $9,875.06 / $23,269.53
| Facility | | $5,181.26 | $9,875.06 | $23,269.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $10,208.14 / $20,678.50
| Facility | | $3,308.00 | $10,208.14 | $20,678.50 |