- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,691.58 / $6,046.81 / $12,288.70
| Facility | | $4,691.58 | $6,046.81 | $12,288.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,801.43 / $7,296.10 / $9,947.03
| Facility | | $4,801.43 | $7,296.10 | $9,947.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,088.57 / $6,378.63 / $7,292.42
| Facility | | $5,088.57 | $6,378.63 | $7,292.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,744.88 / $6,628.84 / $8,621.09
| Facility | | $3,744.88 | $6,628.84 | $8,621.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,400.07 / $8,507.31 / $11,439.08
| Facility | | $6,400.07 | $8,507.31 | $11,439.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $5,316.16 / $8,187.02
| Facility | | $1,286.00 | $5,316.16 | $8,187.02 |