- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,898.76 / $9,154.14 / $14,654.40
| Facility | | $5,898.76 | $9,154.14 | $14,654.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,784.59 / $5,784.59 / $5,784.59
| Facility | | $5,784.59 | $5,784.59 | $5,784.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,631.93 / $7,065.31 / $10,026.48
| Facility | | $3,631.93 | $7,065.31 | $10,026.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,450.86 / $7,302.55 / $12,795.04
| Facility | | $5,450.86 | $7,302.55 | $12,795.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,352.30 / $8,270.20 / $11,082.32
| Facility | | $5,352.30 | $8,270.20 | $11,082.32 |