- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,340.84 / $8,614.56 / $12,317.00
| Facility | | $6,340.84 | $8,614.56 | $12,317.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,102.93 / $8,040.30 / $12,739.96
| Facility | | $5,102.93 | $8,040.30 | $12,739.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,531.56 / $7,636.66 / $13,822.00
| Facility | | $5,531.56 | $7,636.66 | $13,822.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.80 / $85.41 / $137.60
| Facility | | $58.80 | $85.41 | $137.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,974.73 / $8,421.04 / $13,367.26
| Facility | | $5,974.73 | $8,421.04 | $13,367.26 |