- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,246.42 / $9,844.86 / $14,964.00
| Facility | | $7,246.42 | $9,844.86 | $14,964.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,164.52 / $6,164.52 / $8,158.36
| Facility | | $6,164.52 | $6,164.52 | $8,158.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,899.72 / $9,158.50 / $14,565.23
| Facility | | $5,899.72 | $9,158.50 | $14,565.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,321.56 / $8,727.29 / $15,796.00
| Facility | | $6,321.56 | $8,727.29 | $15,796.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.19 / $97.61 / $156.74
| Facility | | $67.19 | $97.61 | $156.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,962.88 / $9,636.35 / $15,859.18
| Facility | | $6,962.88 | $9,636.35 | $15,859.18 |