- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,987.75 / $10,852.00 / $17,087.30
| Facility | | $7,987.75 | $10,852.00 | $17,087.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,504.62 / $10,097.54 / $15,255.56
| Facility | | $6,504.62 | $10,097.54 | $15,255.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,968.28 / $9,774.23 / $17,412.00
| Facility | | $6,968.28 | $9,774.23 | $17,412.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.06 / $102.50 / $172.77
| Facility | | $74.06 | $102.50 | $172.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,675.21 / $10,622.19 / $17,481.65
| Facility | | $7,675.21 | $10,622.19 | $17,481.65 |