- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,258.27 / $8,502.37 / $13,016.00
| Facility | | $6,258.27 | $8,502.37 | $13,016.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,075.91 / $7,935.58 / $12,574.03
| Facility | | $5,075.91 | $7,935.58 | $12,574.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,459.53 / $7,537.21 / $13,642.00
| Facility | | $5,459.53 | $7,537.21 | $13,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.03 / $86.05 / $135.81
| Facility | | $58.03 | $86.05 | $135.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,013.39 / $8,322.29 / $13,696.57
| Facility | | $6,013.39 | $8,322.29 | $13,696.57 |