- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,918.30 / $14,833.40 / $21,590.00
| Facility | | $10,918.30 | $14,833.40 | $21,590.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,715.15 / $13,751.24 / $19,994.38
| Facility | | $8,715.15 | $13,751.24 | $19,994.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,524.76 / $13,149.50 / $23,800.00
| Facility | | $9,524.76 | $13,149.50 | $23,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.24 / $140.10 / $222.26
| Facility | | $101.24 | $140.10 | $222.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,954.35 / $13,990.83 / $22,585.01
| Facility | | $9,954.35 | $13,990.83 | $22,585.01 |