- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,251.00 / $10,175.10 / $15,793.00
| Facility | | $7,251.00 | $10,175.10 | $15,793.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,785.69 / $9,158.50 / $14,536.00
| Facility | | $5,785.69 | $9,158.50 | $14,536.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,325.56 / $8,732.82 / $15,806.00
| Facility | | $6,325.56 | $8,732.82 | $15,806.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.23 / $97.67 / $156.84
| Facility | | $67.23 | $97.67 | $156.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,967.28 / $9,642.45 / $15,869.22
| Facility | | $6,967.28 | $9,642.45 | $15,869.22 |