- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,888.68 / $8,878.57 / $18,043.59
| Facility | | $6,888.68 | $8,878.57 | $18,043.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,854.61 / $9,797.43 / $10,887.11
| Facility | | $5,854.61 | $9,797.43 | $10,887.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,860.73 / $8,600.07 / $9,832.10
| Facility | | $6,860.73 | $8,600.07 | $9,832.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,498.64 / $9,733.16 / $12,658.40
| Facility | | $5,498.64 | $9,733.16 | $12,658.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,468.62 / $11,820.16 / $12,520.18
| Facility | | $10,468.62 | $11,820.16 | $12,520.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $7,805.76 / $12,021.06
| Facility | | $1,286.00 | $7,805.76 | $12,021.06 |