- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,620.68 / $9,290.60 / $13,861.00
| Facility | | $6,620.68 | $9,290.60 | $13,861.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,914.49 / $10,652.96 / $14,821.13
| Facility | | $8,914.49 | $10,652.96 | $14,821.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,391.89 / $8,374.04 / $13,533.89
| Facility | | $5,391.89 | $8,374.04 | $13,533.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,775.69 / $8,101.40 / $14,432.00
| Facility | | $5,775.69 | $8,101.40 | $14,432.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.39 / $89.18 / $143.66
| Facility | | $61.39 | $89.18 | $143.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,036.18 / $8,792.70 / $13,957.19
| Facility | | $6,036.18 | $8,792.70 | $13,957.19 |