- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,884.30 / $14,787.20 / $22,734.00
| Facility | | $10,884.30 | $14,787.20 | $22,734.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,685.86 / $13,712.13 / $19,790.78
| Facility | | $8,685.86 | $13,712.13 | $19,790.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,495.15 / $13,108.62 / $23,726.00
| Facility | | $9,495.15 | $13,108.62 | $23,726.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.93 / $139.02 / $221.57
| Facility | | $100.93 | $139.02 | $221.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,458.42 / $14,474.05 / $23,820.90
| Facility | | $10,458.42 | $14,474.05 | $23,820.90 |