- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,250.93 / $8,771.74 / $13,874.00
| Facility | | $6,250.93 | $8,771.74 | $13,874.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,085.70 / $7,923.94 / $12,765.34
| Facility | | $5,085.70 | $7,923.94 | $12,765.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,453.13 / $7,528.37 / $13,626.00
| Facility | | $5,453.13 | $7,528.37 | $13,626.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.96 / $84.20 / $135.65
| Facility | | $57.96 | $84.20 | $135.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,909.76 / $8,301.64 / $13,177.70
| Facility | | $5,909.76 | $8,301.64 | $13,177.70 |