- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,083.93 / $7,841.36 / $15,935.70
| Facility | | $6,083.93 | $7,841.36 | $15,935.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,093.30 / $7,869.98 / $9,551.86
| Facility | | $5,093.30 | $7,869.98 | $9,551.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,081.15 / $7,622.85 / $8,714.89
| Facility | | $6,081.15 | $7,622.85 | $8,714.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,856.28 / $8,596.12 / $11,179.63
| Facility | | $4,856.28 | $8,596.12 | $11,179.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,604.40 / $9,889.49 / $10,984.64
| Facility | | $7,604.40 | $9,889.49 | $10,984.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $6,893.88 / $10,616.75
| Facility | | $1,286.00 | $6,893.88 | $10,616.75 |