- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,579.18 / $8,579.18 / $10,168.00
| Facility | | $8,579.18 | $8,579.18 | $10,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,907.60 / $11,239.04 / $16,812.91
| Facility | | $6,907.60 | $11,239.04 | $16,812.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,016.71 / $8,684.66 / $14,775.95
| Facility | | $7,016.71 | $8,684.66 | $14,775.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,277.73 / $10,072.62 / $16,487.45
| Facility | | $6,277.73 | $10,072.62 | $16,487.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.61 / $6,413.17 / $9,162.87
| Facility | | $101.61 | $6,413.17 | $9,162.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,143.75 / $9,951.33 / $11,695.31
| Facility | | $7,143.75 | $9,951.33 | $11,695.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,447.23 / $10,614.55 / $13,380.51
| Facility | | $6,447.23 | $10,614.55 | $13,380.51 |