- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,620.76 / $10,353.40 / $15,490.00
| Facility | | $7,620.76 | $10,353.40 | $15,490.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,085.96 / $9,633.82 / $14,762.71
| Facility | | $6,085.96 | $9,633.82 | $14,762.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,648.12 / $9,178.12 / $16,612.00
| Facility | | $6,648.12 | $9,178.12 | $16,612.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.67 / $100.00 / $164.83
| Facility | | $70.67 | $100.00 | $164.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,634.04 / $10,524.53 / $15,516.44
| Facility | | $7,634.04 | $10,524.53 | $15,516.44 |