- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,096.60 / $8,473.37 / $13,510.00
| Facility | | $5,096.60 | $8,473.37 | $13,510.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,179.89 / $7,681.44 / $15,450.68
| Facility | | $6,179.89 | $7,681.44 | $15,450.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,700.91 / $7,302.03 / $11,071.38
| Facility | | $4,700.91 | $7,302.03 | $11,071.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,787.22 / $7,410.82 / $11,479.38
| Facility | | $4,787.22 | $7,410.82 | $11,479.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,269.26 / $7,516.00 / $11,178.21
| Facility | | $5,269.26 | $7,516.00 | $11,178.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,528.80 / $9,054.77 / $12,594.59
| Facility | | $4,528.80 | $9,054.77 | $12,594.59 |