- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,059.25 / $9,590.57 / $13,472.20
| Facility | | $7,059.25 | $9,590.57 | $13,472.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,678.94 / $8,915.04 / $14,178.05
| Facility | | $5,678.94 | $8,915.04 | $14,178.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,158.28 / $8,501.87 / $15,388.00
| Facility | | $6,158.28 | $8,501.87 | $15,388.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62.38 / $90.62 / $145.97
| Facility | | $62.38 | $90.62 | $145.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,783.03 / $9,387.45 / $15,449.55
| Facility | | $6,783.03 | $9,387.45 | $15,449.55 |