- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,172.10 / $10,064.40 / $14,707.00
| Facility | | $7,172.10 | $10,064.40 | $14,707.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,727.10 / $9,065.76 / $14,417.73
| Facility | | $5,727.10 | $9,065.76 | $14,417.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,256.73 / $8,637.79 / $15,634.00
| Facility | | $6,256.73 | $8,637.79 | $15,634.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.51 / $96.61 / $155.13
| Facility | | $66.51 | $96.61 | $155.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,184.60 / $9,904.92 / $14,602.94
| Facility | | $7,184.60 | $9,904.92 | $14,602.94 |