- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,100.70 / $9,381.70 / $31,808.00
| Facility | | $4,100.70 | $9,381.70 | $31,808.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,099.17 / $8,195.67 / $12,396.01
| Facility | | $7,099.17 | $8,195.67 | $12,396.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,930.56 / $13,330.75
| Facility | | $1,474.01 | $5,930.56 | $13,330.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,787.20 / $9,803.46 / $13,887.79
| Facility | | $6,787.20 | $9,803.46 | $13,887.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,932.76 / $8,222.44 / $17,268.14
| Facility | | $5,932.76 | $8,222.44 | $17,268.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,570.24 / $8,222.44 / $17,491.11
| Facility | | $5,570.24 | $8,222.44 | $17,491.11 |