- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,713.06 / $7,338.37 / $18,105.00
| Facility | | $5,713.06 | $7,338.37 | $18,105.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,990.13 / $5,990.13 / $6,750.07
| Facility | | $5,990.13 | $5,990.13 | $6,750.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,330.87 / $6,629.88 / $11,205.48
| Facility | | $4,330.87 | $6,629.88 | $11,205.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,318.94 / $7,986.00 / $11,780.00
| Facility | | $6,318.94 | $7,986.00 | $11,780.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,249.86 / $8,248.43 / $19,365.97
| Facility | | $5,249.86 | $8,248.43 | $19,365.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,952.00 / $7,682.78 / $10,533.66
| Facility | | $3,952.00 | $7,682.78 | $10,533.66 |