- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,813.53 / $10,083.79 / $14,096.90
| Facility | | $6,813.53 | $10,083.79 | $14,096.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,758.00 / $11,872.26 / $20,496.34
| Facility | | $7,758.00 | $11,872.26 | $20,496.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.93 / $10,784.53 / $13,826.32
| Facility | | $7,585.93 | $10,784.53 | $13,826.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,544.23 / $14,711.51 / $21,369.96
| Facility | | $7,544.23 | $14,711.51 | $21,369.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,813.53 / $12,323.40 / $15,452.50
| Facility | | $6,813.53 | $12,323.40 | $15,452.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,800.00 / $7,082.00 / $16,130.79
| Facility | | $3,800.00 | $7,082.00 | $16,130.79 |