- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $9,120.11 / $14,125.38
| Facility | | $6,760.83 | $9,120.11 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $8,317.64 / $12,882.50
| Facility | | $5,248.07 | $8,317.64 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $7,943.28 / $14,454.40
| Facility | | $5,754.40 | $7,943.28 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.10 / $95.50 / $141.25
| Facility | | $63.10 | $95.50 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $8,912.51 / $13,182.57
| Facility | | $6,165.95 | $8,912.51 | $13,182.57 |