- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,369.48 / $6,920.53 / $14,064.40
| Facility | | $5,369.48 | $6,920.53 | $14,064.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,439.96 / $5,439.96 / $7,478.79
| Facility | | $5,439.96 | $5,439.96 | $7,478.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,328.55 / $6,679.45 / $7,636.34
| Facility | | $5,328.55 | $6,679.45 | $7,636.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,286.00 / $7,586.66 / $9,866.78
| Facility | | $4,286.00 | $7,586.66 | $9,866.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,255.95 / $6,255.95 / $6,255.95
| Facility | | $6,255.95 | $6,255.95 | $6,255.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $6,084.32 / $9,370.00
| Facility | | $1,286.00 | $6,084.32 | $9,370.00 |