- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,673.90 / $9,067.04 / $13,463.00
| Facility | | $6,673.90 | $9,067.04 | $13,463.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,429.23 / $8,429.28 / $13,627.61
| Facility | | $5,429.23 | $8,429.28 | $13,627.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,822.11 / $8,037.77 / $14,548.00
| Facility | | $5,822.11 | $8,037.77 | $14,548.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.89 / $89.90 / $144.83
| Facility | | $61.89 | $89.90 | $144.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,685.53 / $9,216.89 / $13,588.56
| Facility | | $6,685.53 | $9,216.89 | $13,588.56 |