- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,517.30 / $14,288.60 / $21,413.00
| Facility | | $10,517.30 | $14,288.60 | $21,413.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,392.91 / $13,285.63 / $19,422.00
| Facility | | $8,392.91 | $13,285.63 | $19,422.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,174.99 / $12,666.62 / $22,926.00
| Facility | | $9,174.99 | $12,666.62 | $22,926.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.52 / $134.33 / $214.09
| Facility | | $97.52 | $134.33 | $214.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,105.78 / $13,986.01 / $23,017.70
| Facility | | $10,105.78 | $13,986.01 | $23,017.70 |