- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,176.61 / $8,391.44 / $12,366.00
| Facility | | $6,176.61 | $8,391.44 | $12,366.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,970.00 / $7,830.85 / $12,408.10
| Facility | | $4,970.00 | $7,830.85 | $12,408.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,388.29 / $7,438.86 / $13,464.00
| Facility | | $5,388.29 | $7,438.86 | $13,464.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.27 / $84.93 / $134.03
| Facility | | $57.27 | $84.93 | $134.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,934.93 / $8,213.70 / $13,517.86
| Facility | | $5,934.93 | $8,213.70 | $13,517.86 |