- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,931.94 / $13,493.40 / $18,959.00
| Facility | | $9,931.94 | $13,493.40 | $18,959.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,931.52 / $12,555.27 / $18,277.79
| Facility | | $7,931.52 | $12,555.27 | $18,277.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,664.33 / $11,961.63 / $21,650.00
| Facility | | $8,664.33 | $11,961.63 | $21,650.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92.10 / $126.86 / $202.18
| Facility | | $92.10 | $126.86 | $202.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,055.11 / $13,190.26 / $20,937.72
| Facility | | $9,055.11 | $13,190.26 | $20,937.72 |