- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,564.06 / $8,460.18 / $17,193.30
| Facility | | $6,564.06 | $8,460.18 | $17,193.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,580.20 / $5,580.20 / $8,734.25
| Facility | | $5,580.20 | $5,580.20 | $8,734.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,452.48 / $8,088.32 / $9,247.04
| Facility | | $6,452.48 | $8,088.32 | $9,247.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,633.40 / $9,274.50 / $11,862.20
| Facility | | $5,633.40 | $9,274.50 | $11,862.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,417.23 / $6,417.23 / $10,044.39
| Facility | | $6,417.23 | $6,417.23 | $10,044.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $7,437.92 / $11,454.58
| Facility | | $1,286.00 | $7,437.92 | $11,454.58 |