- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,628.87 / $8,297.43 / $13,359.90
| Facility | | $3,628.87 | $8,297.43 | $13,359.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,798.85 / $12,019.06
| Facility | | $1,474.01 | $5,798.85 | $12,019.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,006.27 / $8,675.49 / $12,289.88
| Facility | | $6,006.27 | $8,675.49 | $12,289.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,250.14 / $7,276.38 / $19,295.00
| Facility | | $5,250.14 | $7,276.38 | $19,295.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,929.34 / $7,276.38 / $15,478.60
| Facility | | $4,929.34 | $7,276.38 | $15,478.60 |