- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,490.27 / $11,870.50 / $19,707.80
| Facility | | $7,490.27 | $11,870.50 | $19,707.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,986.00 / $10,169.41 / $10,971.52
| Facility | | $6,986.00 | $10,169.41 | $10,971.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,093.40 / $10,626.33 / $18,001.23
| Facility | | $7,093.40 | $10,626.33 | $18,001.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,880.00 / $12,661.21 / $18,129.31
| Facility | | $9,880.00 | $12,661.21 | $18,129.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,360.63 / $12,711.07 / $31,718.89
| Facility | | $6,360.63 | $12,711.07 | $31,718.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,360.63 / $12,136.07 / $17,056.65
| Facility | | $6,360.63 | $12,136.07 | $17,056.65 |