- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,922.11 / $8,811.65 / $14,749.50
| Facility | | $5,922.11 | $8,811.65 | $14,749.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,597.80 / $6,597.80 / $8,367.91
| Facility | | $6,597.80 | $6,597.80 | $8,367.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,108.10 / $7,958.85 / $12,821.58
| Facility | | $5,108.10 | $7,958.85 | $12,821.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,477.94 / $7,683.76 / $13,688.00
| Facility | | $5,477.94 | $7,683.76 | $13,688.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.23 / $86.34 / $136.26
| Facility | | $58.23 | $86.34 | $136.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,922.96 / $8,339.41 / $13,237.66
| Facility | | $5,922.96 | $8,339.41 | $13,237.66 |