- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,089.96 / $8,450.00 / $12,599.90
| Facility | | $6,089.96 | $8,450.00 | $12,599.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,165.42 / $10,108.00 / $11,815.73
| Facility | | $9,165.42 | $10,108.00 | $11,815.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,258.34 / $13,162.11 / $16,874.50
| Facility | | $9,258.34 | $13,162.11 | $16,874.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,373.53 / $10,478.58 / $15,221.20
| Facility | | $5,373.53 | $10,478.58 | $15,221.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,089.96 / $8,874.00 / $13,811.50
| Facility | | $6,089.96 | $8,874.00 | $13,811.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,700.00 / $9,686.00 / $14,417.76
| Facility | | $5,700.00 | $9,686.00 | $14,417.76 |