- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,321.80 / $6,302.63 / $10,231.10
| Facility | | $4,321.80 | $6,302.63 | $10,231.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,958.15 / $14,157.00 / $18,150.00
| Facility | | $9,958.15 | $14,157.00 | $18,150.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,074.81 / $9,896.06 / $14,375.03
| Facility | | $5,074.81 | $9,896.06 | $14,375.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,509.08 / $6,778.02 / $10,838.40
| Facility | | $4,509.08 | $6,778.02 | $10,838.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,273.32 / $9,017.44 / $13,700.11
| Facility | | $5,273.32 | $9,017.44 | $13,700.11 |