- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,772.98 / $9,201.66 / $13,807.00
| Facility | | $6,772.98 | $9,201.66 | $13,807.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,805.33 / $10,805.33 / $10,805.33
| Facility | | $10,805.33 | $10,805.33 | $10,805.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,450.01 / $8,555.67 / $13,606.50
| Facility | | $5,450.01 | $8,555.67 | $13,606.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,908.55 / $8,157.11 / $14,764.00
| Facility | | $5,908.55 | $8,157.11 | $14,764.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62.80 / $91.23 / $146.97
| Facility | | $62.80 | $91.23 | $146.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,507.97 / $9,006.78 / $14,823.06
| Facility | | $6,507.97 | $9,006.78 | $14,823.06 |