- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,259.47 / $7,838.21 / $13,013.30
| Facility | | $5,259.47 | $7,838.21 | $13,013.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,279.05 / $6,461.66 / $10,921.16
| Facility | | $4,279.05 | $6,461.66 | $10,921.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,427.01 / $8,040.48 / $11,438.00
| Facility | | $6,427.01 | $8,040.48 | $11,438.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,200.00 / $8,427.54 / $18,874.59
| Facility | | $4,200.00 | $8,427.54 | $18,874.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,200.00 / $8,214.53 / $11,262.72
| Facility | | $4,200.00 | $8,214.53 | $11,262.72 |