- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,456.73 / $7,009.10 / $20,050.00
| Facility | | $5,456.73 | $7,009.10 | $20,050.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,406.16 / $5,543.64 / $7,949.07
| Facility | | $4,406.16 | $5,543.64 | $7,949.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,224.46 / $6,440.97 / $10,720.61
| Facility | | $4,224.46 | $6,440.97 | $10,720.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,035.42 / $7,468.33 / $10,756.00
| Facility | | $6,035.42 | $7,468.33 | $10,756.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,014.31 / $7,878.34 / $18,890.14
| Facility | | $5,014.31 | $7,878.34 | $18,890.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,952.00 / $7,338.07 / $10,061.03
| Facility | | $3,952.00 | $7,338.07 | $10,061.03 |