- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,133.31 / $9,450.82 / $15,217.00
| Facility | | $4,133.31 | $9,450.82 | $15,217.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,069.41 / $11,863.82
| Facility | | $1,474.01 | $5,069.41 | $11,863.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,841.17 / $9,359.66 / $13,998.24
| Facility | | $6,841.17 | $9,359.66 | $13,998.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,979.94 / $8,287.83 / $17,405.47
| Facility | | $5,979.94 | $8,287.83 | $17,405.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,614.54 / $8,287.83 / $17,630.21
| Facility | | $5,614.54 | $8,287.83 | $17,630.21 |