- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,216.14 / $9,803.71 / $14,200.00
| Facility | | $7,216.14 | $9,803.71 | $14,200.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,756.39 / $9,112.12 / $14,462.40
| Facility | | $5,756.39 | $9,112.12 | $14,462.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,295.15 / $8,690.83 / $15,730.00
| Facility | | $6,295.15 | $8,690.83 | $15,730.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.91 / $97.20 / $156.08
| Facility | | $66.91 | $97.20 | $156.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,933.78 / $9,596.09 / $15,792.92
| Facility | | $6,933.78 | $9,596.09 | $15,792.92 |