- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,038.20 / $11,068.60 / $15,053.30
| Facility | | $8,038.20 | $11,068.60 | $15,053.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,422.48 / $9,970.02 / $15,210.00
| Facility | | $6,422.48 | $9,970.02 | $15,210.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,881.04 / $9,651.85 / $17,194.00
| Facility | | $6,881.04 | $9,651.85 | $17,194.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.42 / $100.00 / $166.60
| Facility | | $71.42 | $100.00 | $166.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,579.12 / $10,489.20 / $17,262.78
| Facility | | $7,579.12 | $10,489.20 | $17,262.78 |