- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,964.33 / $10,170.00 / $13,366.90
| Facility | | $6,964.33 | $10,170.00 | $13,366.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,035.68 / $5,543.92 / $9,376.79
| Facility | | $2,035.68 | $5,543.92 | $9,376.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,330.28 / $10,215.19 / $17,097.91
| Facility | | $7,330.28 | $10,215.19 | $17,097.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,760.18 / $11,400.29 / $16,645.34
| Facility | | $8,760.18 | $11,400.29 | $16,645.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,760.18 / $10,598.09 / $16,645.34
| Facility | | $8,760.18 | $10,598.09 | $16,645.34 |