- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,171.60 / $14,656.00 / $20,583.00
| Facility | | $10,171.60 | $14,656.00 | $20,583.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,677.19 / $13,598.02 / $19,742.34
| Facility | | $8,677.19 | $13,598.02 | $19,742.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,408.70 / $12,989.28 / $23,510.00
| Facility | | $9,408.70 | $12,989.28 | $23,510.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.01 / $137.76 / $219.55
| Facility | | $100.01 | $137.76 | $219.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,833.06 / $14,323.47 / $22,736.52
| Facility | | $9,833.06 | $14,323.47 | $22,736.52 |