- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,571.13 / $8,927.43 / $14,056.90
| Facility | | $6,571.13 | $8,927.43 | $14,056.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,347.08 / $8,322.61 / $13,421.42
| Facility | | $5,347.08 | $8,322.61 | $13,421.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,732.46 / $7,914.01 / $14,324.00
| Facility | | $5,732.46 | $7,914.01 | $14,324.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.93 / $88.52 / $142.60
| Facility | | $60.93 | $88.52 | $142.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,314.02 / $8,738.36 / $14,381.30
| Facility | | $6,314.02 | $8,738.36 | $14,381.30 |