- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,405.86 / $9,414.36 / $14,535.00
| Facility | | $6,405.86 | $9,414.36 | $14,535.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,034.04 / $12,283.09 / $14,540.82
| Facility | | $10,034.04 | $12,283.09 | $14,540.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,950.03 / $14,145.46 / $18,135.20
| Facility | | $9,950.03 | $14,145.46 | $18,135.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,958.44 / $13,609.08 / $17,630.34
| Facility | | $6,958.44 | $13,609.08 | $17,630.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,405.86 / $9,629.25 / $15,397.60
| Facility | | $6,405.86 | $9,629.25 | $15,397.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,491.58 / $12,233.55 / $19,239.06
| Facility | | $7,491.58 | $12,233.55 | $19,239.06 |