- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,088.64 / $11,714.00 / $23,806.00
| Facility | | $9,088.64 | $11,714.00 | $23,806.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,288.08 / $12,826.44 / $14,509.75
| Facility | | $10,288.08 | $12,826.44 | $14,509.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,057.46 / $11,353.73 / $12,980.25
| Facility | | $9,057.46 | $11,353.73 | $12,980.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,254.68 / $12,841.54 / $16,700.97
| Facility | | $7,254.68 | $12,841.54 | $16,700.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,831.29 / $14,346.69 / $16,686.21
| Facility | | $11,831.29 | $14,346.69 | $16,686.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $10,298.60 / $15,860.09
| Facility | | $1,286.00 | $10,298.60 | $15,860.09 |