- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,092.22 / $6,992.76 / $18,579.09
| Facility | | $5,092.22 | $6,992.76 | $18,579.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,904.53 / $5,977.22 / $10,365.12
| Facility | | $3,904.53 | $5,977.22 | $10,365.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,727.88 / $7,450.91 / $10,713.51
| Facility | | $5,727.88 | $7,450.91 | $10,713.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,695.54 / $8,105.51 / $48,537.00
| Facility | | $5,695.54 | $8,105.51 | $48,537.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,952.00 / $7,883.92 / $56,441.00
| Facility | | $3,952.00 | $7,883.92 | $56,441.00 |