- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,212.55 / $6,718.27 / $13,653.30
| Facility | | $5,212.55 | $6,718.27 | $13,653.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,879.53 / $5,658.10 / $6,274.19
| Facility | | $4,879.53 | $5,658.10 | $6,274.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,087.14 / $6,376.85 / $7,290.39
| Facility | | $5,087.14 | $6,376.85 | $7,290.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,160.72 / $7,364.93 / $9,578.40
| Facility | | $4,160.72 | $7,364.93 | $9,578.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,215.32 / $7,215.32 / $7,215.32
| Facility | | $7,215.32 | $7,215.32 | $7,215.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,857.00 / $7,641.34 / $10,358.90
| Facility | | $1,857.00 | $7,641.34 | $10,358.90 |