- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,582.40 / $14,377.10 / $22,535.00
| Facility | | $10,582.40 | $14,377.10 | $22,535.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,610.60 / $13,364.50 / $19,459.18
| Facility | | $8,610.60 | $13,364.50 | $19,459.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,231.81 / $12,745.07 / $23,068.00
| Facility | | $9,231.81 | $12,745.07 | $23,068.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $98.13 / $135.16 / $228.89
| Facility | | $98.13 | $135.16 | $228.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,168.37 / $14,072.63 / $23,160.27
| Facility | | $10,168.37 | $14,072.63 | $23,160.27 |