- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,750.05 / $9,472.14 / $15,103.00
| Facility | | $6,750.05 | $9,472.14 | $15,103.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,496.44 / $8,532.48 / $13,796.32
| Facility | | $5,496.44 | $8,532.48 | $13,796.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.54 / $8,129.49 / $14,714.00
| Facility | | $5,888.54 | $8,129.49 | $14,714.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62.59 / $92.82 / $146.47
| Facility | | $62.59 | $92.82 | $146.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,485.93 / $8,976.28 / $14,772.86
| Facility | | $6,485.93 | $8,976.28 | $14,772.86 |