- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,690.62 / $13,165.50 / $19,372.00
| Facility | | $9,690.62 | $13,165.50 | $19,372.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,610.57 / $13,024.68 / $14,734.00
| Facility | | $12,610.57 | $13,024.68 | $14,734.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,733.78 / $12,242.26 / $18,239.23
| Facility | | $7,733.78 | $12,242.26 | $18,239.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,453.82 / $11,671.01 / $21,124.00
| Facility | | $8,453.82 | $11,671.01 | $21,124.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.86 / $123.78 / $197.27
| Facility | | $89.86 | $123.78 | $197.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,311.45 / $12,886.70 / $21,208.50
| Facility | | $9,311.45 | $12,886.70 | $21,208.50 |