- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,517.54 / $7,613.33 / $12,742.00
| Facility | | $5,517.54 | $7,613.33 | $12,742.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,739.78 / $5,739.78 / $14,340.46
| Facility | | $5,739.78 | $5,739.78 | $14,340.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $8,764.54 / $13,498.84
| Facility | | $2,423.00 | $8,764.54 | $13,498.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,647.16 / $8,565.32 / $14,364.00
| Facility | | $5,647.16 | $8,565.32 | $14,364.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $6,912.69 / $15,371.17
| Facility | | $2,600.00 | $6,912.69 | $15,371.17 |