- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,376.92 / $7,721.33 / $12,432.30
| Facility | | $3,376.92 | $7,721.33 | $12,432.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,779.81 / $7,779.81 / $11,848.97
| Facility | | $7,779.81 | $7,779.81 | $11,848.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,930.56 / $10,890.63
| Facility | | $1,474.01 | $5,930.56 | $10,890.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,589.25 / $8,073.15 / $11,436.59
| Facility | | $5,589.25 | $8,073.15 | $11,436.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,885.62 / $6,771.17 / $19,295.00
| Facility | | $4,885.62 | $6,771.17 | $19,295.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,587.09 / $6,771.17 / $14,403.91
| Facility | | $4,587.09 | $6,771.17 | $14,403.91 |