- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,789.57 / $10,930.90 / $17,370.00
| Facility | | $7,789.57 | $10,930.90 | $17,370.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,340.33 / $9,842.49 / $15,082.48
| Facility | | $6,340.33 | $9,842.49 | $15,082.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,795.40 / $9,381.45 / $16,980.00
| Facility | | $6,795.40 | $9,381.45 | $16,980.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.23 / $104.93 / $168.48
| Facility | | $72.23 | $104.93 | $168.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,484.78 / $10,358.65 / $17,047.91
| Facility | | $7,484.78 | $10,358.65 | $17,047.91 |