- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,534.72 / $8,082.14 / $13,013.30
| Facility | | $3,534.72 | $8,082.14 | $13,013.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $941.25 / $4,203.60 / $10,547.86
| Facility | | $941.25 | $4,203.60 | $10,547.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,850.43 / $8,024.00 / $11,971.01
| Facility | | $5,850.43 | $8,024.00 | $11,971.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,113.92 / $7,087.58 / $14,884.80
| Facility | | $5,113.92 | $7,087.58 | $14,884.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,801.43 / $7,087.58 / $15,076.99
| Facility | | $4,801.43 | $7,087.58 | $15,076.99 |