- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,216.20 / $11,162.40 / $16,828.00
| Facility | | $8,216.20 | $11,162.40 | $16,828.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,554.67 / $10,375.77 / $15,458.44
| Facility | | $6,554.67 | $10,375.77 | $15,458.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,128.18 / $9,554.09 / $17,910.00
| Facility | | $7,128.18 | $9,554.09 | $17,910.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76.19 / $105.43 / $177.71
| Facility | | $76.19 | $105.43 | $177.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,894.73 / $10,926.00 / $17,981.64
| Facility | | $7,894.73 | $10,926.00 | $17,981.64 |