- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,911.47 / $6,777.06 / $11,342.40
| Facility | | $4,911.47 | $6,777.06 | $11,342.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,292.92 / $10,801.84 / $14,691.46
| Facility | | $7,292.92 | $10,801.84 | $14,691.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $7,863.07 / $11,849.64
| Facility | | $2,423.00 | $7,863.07 | $11,849.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,026.85 / $7,624.49 / $12,786.22
| Facility | | $5,026.85 | $7,624.49 | $12,786.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $6,153.38 / $13,682.76
| Facility | | $2,600.00 | $6,153.38 | $13,682.76 |