- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,379.60 / $12,743.00 / $19,570.00
| Facility | | $9,379.60 | $12,743.00 | $19,570.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,484.78 / $11,848.09 / $17,316.00
| Facility | | $7,484.78 | $11,848.09 | $17,316.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,880.91 / $10,897.72 / $20,292.66
| Facility | | $7,880.91 | $10,897.72 | $20,292.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $86.98 / $120.00 / $190.93
| Facility | | $86.98 | $120.00 | $190.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,012.60 / $12,473.08 / $20,527.78
| Facility | | $9,012.60 | $12,473.08 | $20,527.78 |