- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,382.97 / $7,911.08 / $12,214.00
| Facility | | $5,382.97 | $7,911.08 | $12,214.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,089.77 / $11,089.77 / $11,089.77
| Facility | | $11,089.77 | $11,089.77 | $11,089.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,157.47 / $11,597.06 / $14,868.03
| Facility | | $8,157.47 | $11,597.06 | $14,868.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,874.98 / $7,556.34 / $13,539.13
| Facility | | $3,874.98 | $7,556.34 | $13,539.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,382.97 / $8,091.66 / $12,938.90
| Facility | | $5,382.97 | $8,091.66 | $12,938.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,837.00 / $10,765.09 / $16,355.30
| Facility | | $5,837.00 | $10,765.09 | $16,355.30 |