- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,537.19 / $8,881.31 / $12,580.00
| Facility | | $6,537.19 | $8,881.31 | $12,580.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,221.76 / $8,287.36 / $13,145.58
| Facility | | $5,221.76 | $8,287.36 | $13,145.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,702.85 / $7,873.13 / $14,250.00
| Facility | | $5,702.85 | $7,873.13 | $14,250.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.62 / $88.06 / $141.86
| Facility | | $60.62 | $88.06 | $141.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,120.14 / $8,527.20 / $13,522.54
| Facility | | $6,120.14 | $8,527.20 | $13,522.54 |