- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,550.88 / $7,541.33 / $11,874.30
| Facility | | $5,550.88 | $7,541.33 | $11,874.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,518.14 / $7,039.62 / $11,340.72
| Facility | | $4,518.14 | $7,039.62 | $11,340.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,842.42 / $6,792.34 / $12,100.00
| Facility | | $4,842.42 | $6,792.34 | $12,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.47 / $74.77 / $121.77
| Facility | | $51.47 | $74.77 | $121.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,333.68 / $7,381.61 / $12,148.40
| Facility | | $5,333.68 | $7,381.61 | $12,148.40 |