- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,139.98 / $9,700.26 / $14,683.00
| Facility | | $7,139.98 | $9,700.26 | $14,683.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,986.35 / $5,796.04 / $10,304.66
| Facility | | $4,986.35 | $5,796.04 | $10,304.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,745.41 / $9,019.39 / $14,343.98
| Facility | | $5,745.41 | $9,019.39 | $14,343.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,228.71 / $8,599.11 / $15,564.00
| Facility | | $6,228.71 | $8,599.11 | $15,564.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.20 / $96.18 / $154.43
| Facility | | $66.20 | $96.18 | $154.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,860.61 / $9,494.82 / $15,626.26
| Facility | | $6,860.61 | $9,494.82 | $15,626.26 |