- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,247.97 / $9,713.01 / $15,639.20
| Facility | | $4,247.97 | $9,713.01 | $15,639.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,868.10 / $13,356.21
| Facility | | $1,474.01 | $5,868.10 | $13,356.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,686.00 / $9,619.32 / $14,386.59
| Facility | | $6,686.00 | $9,619.32 | $14,386.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,145.84 / $8,517.76 / $17,888.34
| Facility | | $6,145.84 | $8,517.76 | $17,888.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,427.40 / $8,282.75 / $15,356.51
| Facility | | $5,427.40 | $8,282.75 | $15,356.51 |