- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,882.20 / $6,292.49 / $12,788.00
| Facility | | $4,882.20 | $6,292.49 | $12,788.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,571.73 / $7,571.73 / $8,023.44
| Facility | | $7,571.73 | $7,571.73 | $8,023.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,857.10 / $6,088.49 / $6,960.72
| Facility | | $4,857.10 | $6,088.49 | $6,960.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,897.04 / $6,898.16 / $8,971.36
| Facility | | $3,897.04 | $6,898.16 | $8,971.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,707.49 / $8,707.49 / $9,226.95
| Facility | | $8,707.49 | $8,707.49 | $9,226.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $5,532.16 / $8,519.66
| Facility | | $1,286.00 | $5,532.16 | $8,519.66 |