- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,222.75 / $9,632.70 / $10,900.90
| Facility | | $6,222.75 | $9,632.70 | $10,900.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,319.78 / $9,558.48 / $12,909.45
| Facility | | $6,319.78 | $9,558.48 | $12,909.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,746.26 / $8,947.15 / $13,538.60
| Facility | | $5,746.26 | $8,947.15 | $13,538.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,015.00 / $10,722.00 / $19,082.00
| Facility | | $8,015.00 | $10,722.00 | $19,082.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $11,200.00 / $14,816.84
| Facility | | $5,274.00 | $11,200.00 | $14,816.84 |