- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,951.22 / $7,636.42 / $12,678.30
| Facility | | $5,951.22 | $7,636.42 | $12,678.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,988.00 / $3,415.70 / $9,627.01
| Facility | | $2,988.00 | $3,415.70 | $9,627.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,215.17 / $7,596.63 / $12,839.43
| Facility | | $5,215.17 | $7,596.63 | $12,839.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,582.35 / $8,347.43 / $13,703.00
| Facility | | $6,582.35 | $8,347.43 | $13,703.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,091.88 / $8,210.59 / $22,189.85
| Facility | | $4,091.88 | $8,210.59 | $22,189.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,091.88 / $8,003.05 / $10,972.77
| Facility | | $4,091.88 | $8,003.05 | $10,972.77 |