- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,695.00 / $9,095.70 / $12,978.00
| Facility | | $6,695.00 | $9,095.70 | $12,978.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,451.64 / $8,462.92 / $13,683.85
| Facility | | $5,451.64 | $8,462.92 | $13,683.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.52 / $8,063.19 / $14,594.00
| Facility | | $5,840.52 | $8,063.19 | $14,594.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62.08 / $90.18 / $145.28
| Facility | | $62.08 | $90.18 | $145.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,433.04 / $8,903.07 / $14,652.38
| Facility | | $6,433.04 | $8,903.07 | $14,652.38 |