- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,124.46 / $11,037.80 / $17,056.00
| Facility | | $8,124.46 | $11,037.80 | $17,056.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,425.73 / $10,219.39 / $15,285.72
| Facility | | $6,425.73 | $10,219.39 | $15,285.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,087.54 / $9,784.78 / $17,710.00
| Facility | | $7,087.54 | $9,784.78 | $17,710.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.34 / $104.25 / $175.73
| Facility | | $75.34 | $104.25 | $175.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,806.57 / $10,803.99 / $17,780.84
| Facility | | $7,806.57 | $10,803.99 | $17,780.84 |