- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,938.14 / $9,426.03 / $14,713.00
| Facility | | $6,938.14 | $9,426.03 | $14,713.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,582.94 / $8,764.34 / $14,171.22
| Facility | | $5,582.94 | $8,764.34 | $14,171.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,052.62 / $8,489.86 / $15,124.00
| Facility | | $6,052.62 | $8,489.86 | $15,124.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.34 / $95.40 / $150.07
| Facility | | $64.34 | $95.40 | $150.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,666.66 / $9,226.40 / $15,184.50
| Facility | | $6,666.66 | $9,226.40 | $15,184.50 |