- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,616.17 / $10,347.20 / $15,442.00
| Facility | | $7,616.17 | $10,347.20 | $15,442.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,078.63 / $9,622.23 / $14,744.95
| Facility | | $6,078.63 | $9,622.23 | $14,744.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,644.12 / $9,172.61 / $16,602.00
| Facility | | $6,644.12 | $9,172.61 | $16,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.62 / $100.00 / $164.73
| Facility | | $70.62 | $100.00 | $164.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,318.16 / $10,128.04 / $16,668.41
| Facility | | $7,318.16 | $10,128.04 | $16,668.41 |