- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,502.60 / $14,738.00 / $20,931.00
| Facility | | $10,502.60 | $14,738.00 | $20,931.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,550.86 / $13,272.57 / $19,422.00
| Facility | | $8,550.86 | $13,272.57 | $19,422.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,162.18 / $12,648.94 / $22,894.00
| Facility | | $9,162.18 | $12,648.94 | $22,894.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.39 / $134.15 / $213.80
| Facility | | $97.39 | $134.15 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,091.68 / $13,966.48 / $22,985.58
| Facility | | $10,091.68 | $13,966.48 | $22,985.58 |