- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,185.00 / $9,588.96 / $17,095.40
| Facility | | $2,185.00 | $9,588.96 | $17,095.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,246.70 / $8,351.92 / $11,971.90
| Facility | | $5,246.70 | $8,351.92 | $11,971.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,436.46 / $9,091.95 / $15,570.83
| Facility | | $4,436.46 | $9,091.95 | $15,570.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,043.19 / $8,936.58 / $12,705.70
| Facility | | $8,043.19 | $8,936.58 | $12,705.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,517.50 / $11,026.17 / $27,436.42
| Facility | | $5,517.50 | $11,026.17 | $27,436.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,681.94 / $10,014.46 / $14,606.81
| Facility | | $6,681.94 | $10,014.46 | $14,606.81 |