- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,019.87 / $10,895.70 / $17,156.00
| Facility | | $8,019.87 | $10,895.70 | $17,156.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,505.47 / $11,505.47 / $11,505.47
| Facility | | $11,505.47 | $11,505.47 | $11,505.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,504.51 / $10,132.32 / $15,210.39
| Facility | | $6,504.51 | $10,132.32 | $15,210.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,996.30 / $9,658.81 / $17,482.00
| Facility | | $6,996.30 | $9,658.81 | $17,482.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.37 / $102.91 / $173.47
| Facility | | $74.37 | $102.91 | $173.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,706.07 / $10,664.89 / $17,551.93
| Facility | | $7,706.07 | $10,664.89 | $17,551.93 |