- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,895.93 / $9,368.69 / $13,993.00
| Facility | | $6,895.93 | $9,368.69 | $13,993.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,816.56 / $9,978.00 / $11,213.28
| Facility | | $4,816.56 | $9,978.00 | $11,213.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,460.06 / $8,717.96 / $13,864.62
| Facility | | $5,460.06 | $8,717.96 | $13,864.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,015.81 / $8,305.18 / $15,032.00
| Facility | | $6,015.81 | $8,305.18 | $15,032.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.94 / $92.89 / $149.63
| Facility | | $63.94 | $92.89 | $149.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,626.11 / $9,170.27 / $15,092.13
| Facility | | $6,626.11 | $9,170.27 | $15,092.13 |