- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,874.83 / $9,340.02 / $14,102.00
| Facility | | $6,874.83 | $9,340.02 | $14,102.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,531.25 / $8,683.19 / $13,809.31
| Facility | | $5,531.25 | $8,683.19 | $13,809.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,964.43 / $7,994.28 / $14,986.00
| Facility | | $5,964.43 | $7,994.28 | $14,986.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.75 / $92.61 / $149.19
| Facility | | $63.75 | $92.61 | $149.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,605.83 / $9,142.20 / $15,045.94
| Facility | | $6,605.83 | $9,142.20 | $15,045.94 |