- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,954.79 / $12,566.00 / $18,540.00
| Facility | | $8,954.79 | $12,566.00 | $18,540.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,288.76 / $11,357.60 / $17,094.64
| Facility | | $7,288.76 | $11,357.60 | $17,094.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,811.90 / $10,957.55 / $19,520.00
| Facility | | $7,811.90 | $10,957.55 | $19,520.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.04 / $114.91 / $184.00
| Facility | | $83.04 | $114.91 | $184.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,604.42 / $11,908.18 / $19,598.08
| Facility | | $8,604.42 | $11,908.18 | $19,598.08 |