- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,328.99 / $10,284.50 / $15,516.00
| Facility | | $7,328.99 | $10,284.50 | $15,516.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,851.60 / $9,262.84 / $14,675.75
| Facility | | $5,851.60 | $9,262.84 | $14,675.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,393.60 / $8,968.12 / $15,976.00
| Facility | | $6,393.60 | $8,968.12 | $15,976.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.95 / $100.00 / $158.52
| Facility | | $67.95 | $100.00 | $158.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,042.22 / $9,746.16 / $16,039.90
| Facility | | $7,042.22 | $9,746.16 | $16,039.90 |