- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,612.07 / $8,484.39 / $14,086.10
| Facility | | $6,612.07 | $8,484.39 | $14,086.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,808.00 / $5,976.00 / $9,504.00
| Facility | | $4,808.00 | $5,976.00 | $9,504.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,148.35 / $7,723.33 / $13,053.57
| Facility | | $5,148.35 | $7,723.33 | $13,053.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,313.28 / $9,049.58 / $13,174.00
| Facility | | $7,313.28 | $9,049.58 | $13,174.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,546.25 / $9,085.23 / $22,559.94
| Facility | | $4,546.25 | $9,085.23 | $22,559.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,810.47 / $8,891.74 / $12,485.09
| Facility | | $5,810.47 | $8,891.74 | $12,485.09 |