- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,941.11 / $13,505.80 / $20,162.00
| Facility | | $9,941.11 | $13,505.80 | $20,162.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,087.84 / $12,555.27 / $18,705.57
| Facility | | $8,087.84 | $12,555.27 | $18,705.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,672.33 / $11,972.68 / $21,670.00
| Facility | | $8,672.33 | $11,972.68 | $21,670.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92.18 / $126.98 / $202.37
| Facility | | $92.18 | $126.98 | $202.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,552.14 / $13,219.78 / $21,756.68
| Facility | | $9,552.14 | $13,219.78 | $21,756.68 |