- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,768.63 / $7,434.98 / $15,109.90
| Facility | | $5,768.63 | $7,434.98 | $15,109.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.68 / $6,508.88 / $10,151.20
| Facility | | $4,168.68 | $6,508.88 | $10,151.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,790.76 / $7,258.84 / $8,298.73
| Facility | | $5,790.76 | $7,258.84 | $8,298.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,604.60 / $8,150.63 / $10,600.24
| Facility | | $4,604.60 | $8,150.63 | $10,600.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,793.97 / $7,485.21 / $10,075.20
| Facility | | $4,793.97 | $7,485.21 | $10,075.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $7,071.93 / $10,066.53
| Facility | | $1,286.00 | $7,071.93 | $10,066.53 |