- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,410.33 / $6,973.18 / $14,171.30
| Facility | | $5,410.33 | $6,973.18 | $14,171.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,957.22 / $7,957.22 / $7,957.22
| Facility | | $7,957.22 | $7,957.22 | $7,957.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.43 / $6,793.37 / $7,766.58
| Facility | | $5,419.43 | $6,793.37 | $7,766.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,318.60 / $7,644.38 / $9,941.84
| Facility | | $4,318.60 | $7,644.38 | $9,941.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,150.79 / $9,150.79 / $9,150.79
| Facility | | $9,150.79 | $9,150.79 | $9,150.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,857.00 / $7,931.28 / $10,751.96
| Facility | | $1,857.00 | $7,931.28 | $10,751.96 |