- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,846.70 / $14,736.10 / $22,326.00
| Facility | | $10,846.70 | $14,736.10 | $22,326.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,656.56 / $13,668.80 / $19,859.96
| Facility | | $8,656.56 | $13,668.80 | $19,859.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,462.33 / $13,063.31 / $23,644.00
| Facility | | $9,462.33 | $13,063.31 | $23,644.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.58 / $138.54 / $220.80
| Facility | | $100.58 | $138.54 | $220.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,422.28 / $14,424.02 / $23,738.58
| Facility | | $10,422.28 | $14,424.02 | $23,738.58 |