- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,077.10 / $6,543.71 / $13,298.50
| Facility | | $5,077.10 | $6,543.71 | $13,298.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,994.84 / $5,821.81 / $6,790.63
| Facility | | $3,994.84 | $5,821.81 | $6,790.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,793.92 / $6,009.28 / $6,870.16
| Facility | | $4,793.92 | $6,009.28 | $6,870.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,052.62 / $7,173.56 / $9,329.53
| Facility | | $4,052.62 | $7,173.56 | $9,329.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,594.07 / $6,695.08 / $7,809.22
| Facility | | $4,594.07 | $6,695.08 | $7,809.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $5,753.02 / $8,859.79
| Facility | | $1,286.00 | $5,753.02 | $8,859.79 |