- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,793.24 / $10,936.00 / $17,179.09
| Facility | | $7,793.24 | $10,936.00 | $17,179.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,340.33 / $9,842.49 / $15,082.48
| Facility | | $6,340.33 | $9,842.49 | $15,082.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,798.60 / $9,536.20 / $16,988.00
| Facility | | $6,798.60 | $9,536.20 | $16,988.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.27 / $100.00 / $168.56
| Facility | | $72.27 | $100.00 | $168.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,488.31 / $10,363.53 / $17,055.95
| Facility | | $7,488.31 | $10,363.53 | $17,055.95 |