- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,041.10 / $13,641.70 / $20,421.00
| Facility | | $10,041.10 | $13,641.70 | $20,421.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,091.64 / $11,091.64 / $17,273.64
| Facility | | $11,091.64 | $11,091.64 | $17,273.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,169.99 / $12,682.79 / $18,895.56
| Facility | | $8,169.99 | $12,682.79 | $18,895.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,759.58 / $12,093.12 / $21,888.00
| Facility | | $8,759.58 | $12,093.12 | $21,888.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.11 / $128.25 / $204.40
| Facility | | $93.11 | $128.25 | $204.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,648.23 / $13,352.77 / $21,975.55
| Facility | | $9,648.23 | $13,352.77 | $21,975.55 |