- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,869.78 / $8,848.26 / $14,246.80
| Facility | | $3,869.78 | $8,848.26 | $14,246.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,364.99 / $8,209.20 / $8,920.02
| Facility | | $5,364.99 | $8,209.20 | $8,920.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,930.56 / $12,636.72
| Facility | | $1,474.01 | $5,930.56 | $12,636.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,405.00 / $9,624.43 / $13,910.11
| Facility | | $6,405.00 | $9,624.43 | $13,910.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,598.68 / $7,759.43 / $16,295.76
| Facility | | $5,598.68 | $7,759.43 | $16,295.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,256.58 / $7,759.43 / $16,506.16
| Facility | | $5,256.58 | $7,759.43 | $16,506.16 |