- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,734.45 / $9,149.31 / $14,406.20
| Facility | | $6,734.45 | $9,149.31 | $14,406.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,420.47 / $8,509.29 / $13,532.75
| Facility | | $5,420.47 | $8,509.29 | $13,532.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,874.94 / $8,110.70 / $14,680.00
| Facility | | $5,874.94 | $8,110.70 | $14,680.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62.45 / $90.72 / $146.13
| Facility | | $62.45 | $90.72 | $146.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,470.94 / $8,955.53 / $14,738.72
| Facility | | $6,470.94 | $8,955.53 | $14,738.72 |