- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,022.19 / $4,876.59 / $5,622.43
| Facility | | $4,022.19 | $4,876.59 | $5,622.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,988.29 / $6,131.36 / $11,709.16
| Facility | | $4,988.29 | $6,131.36 | $11,709.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $800.00 / $850.00 / $1,246.00
| Facility | | $800.00 | $850.00 | $1,246.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,499.06 / $3,886.47 / $9,774.78
| Facility | | $3,499.06 | $3,886.47 | $9,774.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $4,904.35 / $8,465.71
| Facility | | $2,332.00 | $4,904.35 | $8,465.71 |