- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,404.37 / $12,776.60 / $19,949.00
| Facility | | $9,404.37 | $12,776.60 | $19,949.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,654.70 / $11,882.87 / $17,703.80
| Facility | | $7,654.70 | $11,882.87 | $17,703.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,204.10 / $11,326.25 / $20,500.00
| Facility | | $8,204.10 | $11,326.25 | $20,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.20 / $120.12 / $191.44
| Facility | | $87.20 | $120.12 | $191.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,036.40 / $12,506.03 / $20,582.00
| Facility | | $9,036.40 | $12,506.03 | $20,582.00 |