- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.11 / $9,396.12 / $14,794.80
| Facility | | $6,916.11 | $9,396.12 | $14,794.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,630.87 / $8,741.15 / $14,133.73
| Facility | | $5,630.87 | $8,741.15 | $14,133.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,033.42 / $8,329.49 / $15,076.00
| Facility | | $6,033.42 | $8,329.49 | $15,076.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.30 / $91.95 / $148.13
| Facility | | $63.30 | $91.95 | $148.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,645.50 / $9,197.11 / $15,136.30
| Facility | | $6,645.50 | $9,197.11 | $15,136.30 |