- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,316.07 / $8,580.91 / $13,112.00
| Facility | | $6,316.07 | $8,580.91 | $13,112.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,137.97 / $8,005.39 / $12,896.56
| Facility | | $5,137.97 | $8,005.39 | $12,896.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,509.95 / $7,606.82 / $13,768.00
| Facility | | $5,509.95 | $7,606.82 | $13,768.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.57 / $85.08 / $137.06
| Facility | | $58.57 | $85.08 | $137.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,064.52 / $8,379.89 / $13,315.03
| Facility | | $6,064.52 | $8,379.89 | $13,315.03 |