- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,272.03 / $6,794.93 / $13,809.10
| Facility | | $5,272.03 | $6,794.93 | $13,809.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,911.18 / $6,158.30 / $11,177.67
| Facility | | $4,911.18 | $6,158.30 | $11,177.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,287.37 / $6,627.83 / $7,577.32
| Facility | | $5,287.37 | $6,627.83 | $7,577.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,208.20 / $7,448.96 / $9,687.70
| Facility | | $4,208.20 | $7,448.96 | $9,687.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,585.49 / $7,245.72 / $12,854.32
| Facility | | $6,585.49 | $7,245.72 | $12,854.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $5,973.88 / $9,199.93
| Facility | | $1,286.00 | $5,973.88 | $9,199.93 |