- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,730.89 / $7,986.54 / $14,054.00
| Facility | | $4,730.89 | $7,986.54 | $14,054.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,956.78 / $4,115.12 / $8,803.24
| Facility | | $3,956.78 | $4,115.12 | $8,803.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,379.22 / $7,660.58 / $12,550.15
| Facility | | $5,379.22 | $7,660.58 | $12,550.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,303.49 / $7,361.64 / $10,597.39
| Facility | | $4,303.49 | $7,361.64 | $10,597.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,826.75 / $14,826.75 / $17,400.45
| Facility | | $14,826.75 | $14,826.75 | $17,400.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $6,960.20 / $9,941.85
| Facility | | $1,787.00 | $6,960.20 | $9,941.85 |