- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,419.75 / $9,008.64 / $14,494.00
| Facility | | $6,419.75 | $9,008.64 | $14,494.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,169.39 / $8,145.02 / $12,905.90
| Facility | | $5,169.39 | $8,145.02 | $12,905.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,600.40 / $7,731.69 / $13,994.00
| Facility | | $5,600.40 | $7,731.69 | $13,994.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.53 / $86.48 / $139.31
| Facility | | $59.53 | $86.48 | $139.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,168.56 / $8,537.04 / $14,049.98
| Facility | | $6,168.56 | $8,537.04 | $14,049.98 |