- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,707.99 / $11,830.50 / $18,628.00
| Facility | | $8,707.99 | $11,830.50 | $18,628.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,087.13 / $11,001.80 / $16,515.63
| Facility | | $7,087.13 | $11,001.80 | $16,515.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,596.60 / $10,587.00 / $18,982.00
| Facility | | $7,596.60 | $10,587.00 | $18,982.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.75 / $111.74 / $184.00
| Facility | | $80.75 | $111.74 | $184.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,367.27 / $11,579.97 / $19,057.93
| Facility | | $8,367.27 | $11,579.97 | $19,057.93 |