- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,076.10 / $15,047.70 / $22,665.00
| Facility | | $11,076.10 | $15,047.70 | $22,665.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,913.51 / $13,937.63 / $20,280.00
| Facility | | $8,913.51 | $13,937.63 | $20,280.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,662.43 / $13,339.56 / $24,144.00
| Facility | | $9,662.43 | $13,339.56 | $24,144.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.71 / $141.47 / $225.47
| Facility | | $102.71 | $141.47 | $225.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,642.68 / $14,729.05 / $24,240.58
| Facility | | $10,642.68 | $14,729.05 | $24,240.58 |