- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,086.10 / $13,702.80 / $20,237.00
| Facility | | $10,086.10 | $13,702.80 | $20,237.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,502.67 / $15,502.67 / $15,502.67
| Facility | | $15,502.67 | $15,502.67 | $15,502.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,115.95 / $12,740.76 / $18,981.91
| Facility | | $8,115.95 | $12,740.76 | $18,981.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,798.79 / $12,147.27 / $21,986.00
| Facility | | $8,798.79 | $12,147.27 | $21,986.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.53 / $128.83 / $205.32
| Facility | | $93.53 | $128.83 | $205.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,691.43 / $13,412.56 / $22,073.94
| Facility | | $9,691.43 | $13,412.56 | $22,073.94 |