- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,549.64 / $7,094.35 / $10,795.00
| Facility | | $4,549.64 | $7,094.35 | $10,795.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,849.50 / $4,849.50 / $6,861.92
| Facility | | $4,849.50 | $4,849.50 | $6,861.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,479.85 / $7,155.18 / $11,375.62
| Facility | | $4,479.85 | $7,155.18 | $11,375.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,236.25 / $5,181.96 / $6,325.08
| Facility | | $4,236.25 | $5,181.96 | $6,325.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.79 / $83.28 / $1,062.00
| Facility | | $57.79 | $83.28 | $1,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,438.59 / $7,526.80 / $12,387.35
| Facility | | $5,438.59 | $7,526.80 | $12,387.35 |