- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,558.44 / $10,166.29 / $16,878.50
| Facility | | $6,558.44 | $10,166.29 | $16,878.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,560.35 / $6,849.33 / $13,594.85
| Facility | | $4,560.35 | $6,849.33 | $13,594.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,412.00 / $9,276.73 / $15,378.44
| Facility | | $5,412.00 | $9,276.73 | $15,378.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,025.69 / $10,843.58 / $15,056.00
| Facility | | $8,025.69 | $10,843.58 | $15,056.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,447.50 / $10,886.28 / $27,097.43
| Facility | | $5,447.50 | $10,886.28 | $27,097.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,447.50 / $10,393.83 / $14,608.02
| Facility | | $5,447.50 | $10,393.83 | $14,608.02 |