- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,706.29 / $7,354.63 / $14,946.60
| Facility | | $5,706.29 | $7,354.63 | $14,946.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,086.77 / $8,086.77 / $8,086.77
| Facility | | $8,086.77 | $8,086.77 | $8,086.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,498.24 / $6,892.16 / $7,879.52
| Facility | | $5,498.24 | $6,892.16 | $7,879.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,554.84 / $8,062.54 / $10,485.68
| Facility | | $4,554.84 | $8,062.54 | $10,485.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,785.59 / $8,125.91 / $9,299.79
| Facility | | $5,785.59 | $8,125.91 | $9,299.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $6,465.96 / $9,957.73
| Facility | | $1,286.00 | $6,465.96 | $9,957.73 |