- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,217.12 / $11,163.70 / $17,090.00
| Facility | | $8,217.12 | $11,163.70 | $17,090.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,505.60 / $10,387.37 / $15,475.71
| Facility | | $6,505.60 | $10,387.37 | $15,475.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,168.38 / $9,896.37 / $17,912.00
| Facility | | $7,168.38 | $9,896.37 | $17,912.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76.20 / $110.69 / $177.73
| Facility | | $76.20 | $110.69 | $177.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,895.61 / $10,927.22 / $17,983.65
| Facility | | $7,895.61 | $10,927.22 | $17,983.65 |