- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,115.85 / $9,371.00 / $13,268.30
| Facility | | $5,115.85 | $9,371.00 | $13,268.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,721.26 / $5,721.26 / $10,140.29
| Facility | | $5,721.26 | $5,721.26 | $10,140.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,314.96 / $10,232.59 / $16,844.25
| Facility | | $6,314.96 | $10,232.59 | $16,844.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,318.94 / $8,429.70 / $14,997.80
| Facility | | $5,318.94 | $8,429.70 | $14,997.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,948.91 / $8,036.00 / $17,734.93
| Facility | | $3,948.91 | $8,036.00 | $17,734.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $7,953.43 / $15,760.18
| Facility | | $3,308.00 | $7,953.43 | $15,760.18 |