- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,016.05 / $8,173.30 / $12,869.40
| Facility | | $6,016.05 | $8,173.30 | $12,869.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.32 / $7,633.05 / $12,296.72
| Facility | | $4,804.32 | $7,633.05 | $12,296.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.22 / $7,245.49 / $13,114.00
| Facility | | $5,248.22 | $7,245.49 | $13,114.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.04 / $75.59 / $123.12
| Facility | | $52.04 | $75.59 | $123.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,780.65 / $8,000.20 / $13,166.46
| Facility | | $5,780.65 | $8,000.20 | $13,166.46 |