- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,663.88 / $9,461.84 / $15,708.90
| Facility | | $6,663.88 | $9,461.84 | $15,708.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,927.35 / $8,300.26 / $11,952.00
| Facility | | $5,927.35 | $8,300.26 | $11,952.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,682.93 / $8,513.36 / $14,421.81
| Facility | | $5,682.93 | $8,513.36 | $14,421.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,155.80 / $10,092.14 / $14,511.26
| Facility | | $8,155.80 | $10,092.14 | $14,511.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,070.00 / $10,131.89 / $25,411.81
| Facility | | $5,070.00 | $10,131.89 | $25,411.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,070.00 / $9,673.56 / $13,595.71
| Facility | | $5,070.00 | $9,673.56 | $13,595.71 |