- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,069.28 / $11,203.30 / $18,600.09
| Facility | | $7,069.28 | $11,203.30 | $18,600.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,642.02 / $9,950.14 / $16,855.75
| Facility | | $6,642.02 | $9,950.14 | $16,855.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,655.00 / $11,949.58 / $17,182.04
| Facility | | $9,655.00 | $11,949.58 | $17,182.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,003.13 / $11,996.65 / $29,700.50
| Facility | | $6,003.13 | $11,996.65 | $29,700.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,003.13 / $11,453.96 / $16,097.98
| Facility | | $6,003.13 | $11,453.96 | $16,097.98 |