- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,701.35 / $7,745.75 / $11,567.00
| Facility | | $5,701.35 | $7,745.75 | $11,567.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,613.29 / $6,613.29 / $8,274.64
| Facility | | $6,613.29 | $6,613.29 | $8,274.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,637.62 / $7,225.80 / $11,640.64
| Facility | | $4,637.62 | $7,225.80 | $11,640.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,973.68 / $6,866.47 / $12,428.00
| Facility | | $4,973.68 | $6,866.47 | $12,428.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.87 / $76.80 / $125.00
| Facility | | $52.87 | $76.80 | $125.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,478.26 / $7,581.70 / $12,477.71
| Facility | | $5,478.26 | $7,581.70 | $12,477.71 |