- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,156.04 / $7,612.85 / $10,779.00
| Facility | | $4,156.04 | $7,612.85 | $10,779.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,046.85 / $5,046.85 / $8,703.68
| Facility | | $5,046.85 | $5,046.85 | $8,703.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,500.00 / $8,928.74 / $14,562.61
| Facility | | $5,500.00 | $8,928.74 | $14,562.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,321.02 / $6,848.16 / $12,183.97
| Facility | | $4,321.02 | $6,848.16 | $12,183.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $6,912.85 / $14,407.56
| Facility | | $3,308.00 | $6,912.85 | $14,407.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,000.00 / $6,843.54 / $12,803.31
| Facility | | $3,000.00 | $6,843.54 | $12,803.31 |