- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,672.13 / $10,423.20 / $15,470.00
| Facility | | $7,672.13 | $10,423.20 | $15,470.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,243.24 / $9,691.78 / $14,917.50
| Facility | | $6,243.24 | $9,691.78 | $14,917.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,692.94 / $9,240.01 / $16,724.00
| Facility | | $6,692.94 | $9,240.01 | $16,724.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.14 / $100.00 / $165.94
| Facility | | $71.14 | $100.00 | $165.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,371.94 / $10,202.48 / $16,790.90
| Facility | | $7,371.94 | $10,202.48 | $16,790.90 |