- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,375.78 / $10,020.60 / $14,660.00
| Facility | | $7,375.78 | $10,020.60 | $14,660.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,837.61 / $9,284.06 / $14,625.00
| Facility | | $5,837.61 | $9,284.06 | $14,625.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,399.04 / $8,576.81 / $16,078.00
| Facility | | $6,399.04 | $8,576.81 | $16,078.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.39 / $99.35 / $159.53
| Facility | | $68.39 | $99.35 | $159.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,388.64 / $10,186.21 / $15,017.66
| Facility | | $7,388.64 | $10,186.21 | $15,017.66 |