- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,364.39 / $6,364.75 / $10,332.00
| Facility | | $4,364.39 | $6,364.75 | $10,332.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,482.41 / $13,480.66 / $17,282.90
| Facility | | $9,482.41 | $13,480.66 | $17,282.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,124.83 / $9,908.37 / $12,532.31
| Facility | | $5,124.83 | $9,908.37 | $12,532.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,553.52 / $6,844.83 / $10,945.20
| Facility | | $4,553.52 | $6,844.83 | $10,945.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,325.30 / $8,696.07 / $13,675.85
| Facility | | $5,325.30 | $8,696.07 | $13,675.85 |