- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,972.22 / $7,409.46 / $11,324.50
| Facility | | $4,972.22 | $7,409.46 | $11,324.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,906.81 / $8,536.93 / $14,802.31
| Facility | | $5,906.81 | $8,536.93 | $14,802.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,977.38 / $7,842.49 / $12,426.53
| Facility | | $4,977.38 | $7,842.49 | $12,426.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,396.30 / $7,416.20 / $13,484.00
| Facility | | $5,396.30 | $7,416.20 | $13,484.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.71 / $91.02 / $2,470.00
| Facility | | $59.71 | $91.02 | $2,470.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,971.00 / $7,413.00 / $11,881.43
| Facility | | $3,971.00 | $7,413.00 | $11,881.43 |