- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,501.37 / $6,654.31 / $11,047.70
| Facility | | $4,501.37 | $6,654.31 | $11,047.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,408.77 / $6,604.60 / $11,188.33
| Facility | | $4,408.77 | $6,604.60 | $11,188.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,735.81 / $7,097.59 / $10,453.00
| Facility | | $5,735.81 | $7,097.59 | $10,453.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,952.00 / $7,154.64 / $19,714.29
| Facility | | $3,952.00 | $7,154.64 | $19,714.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,952.00 / $6,973.79 / $9,561.58
| Facility | | $3,952.00 | $6,973.79 | $9,561.58 |