- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,933.07 / $6,358.06 / $12,921.30
| Facility | | $4,933.07 | $6,358.06 | $12,921.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,982.48 / $6,982.48 / $8,570.87
| Facility | | $6,982.48 | $6,982.48 | $8,570.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,954.38 / $6,210.42 / $7,100.12
| Facility | | $4,954.38 | $6,210.42 | $7,100.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,937.65 / $6,970.05 / $9,064.85
| Facility | | $3,937.65 | $6,970.05 | $9,064.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,225.90 / $6,225.90 / $9,856.50
| Facility | | $6,225.90 | $6,225.90 | $9,856.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $5,589.81 / $8,608.44
| Facility | | $1,286.00 | $5,589.81 | $8,608.44 |