- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,221.20 / $7,991.05 / $31,778.00
| Facility | | $6,221.20 | $7,991.05 | $31,778.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,760.00 / $7,149.66 / $9,035.59
| Facility | | $3,760.00 | $7,149.66 | $9,035.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,838.02 / $7,328.33 / $15,288.51
| Facility | | $4,838.02 | $7,328.33 | $15,288.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,880.96 / $8,726.10 / $15,240.22
| Facility | | $6,880.96 | $8,726.10 | $15,240.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,716.79 / $8,982.07 / $21,406.13
| Facility | | $5,716.79 | $8,982.07 | $21,406.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,277.50 / $8,188.50 / $11,470.54
| Facility | | $4,277.50 | $8,188.50 | $11,470.54 |