- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,149.40 / $13,551.00 / $19,722.00
| Facility | | $10,149.40 | $13,551.00 | $19,722.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,030.35 / $12,771.35 / $18,665.96
| Facility | | $8,030.35 | $12,771.35 | $18,665.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,854.02 / $12,223.51 / $22,124.00
| Facility | | $8,854.02 | $12,223.51 | $22,124.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $94.11 / $129.63 / $206.60
| Facility | | $94.11 | $129.63 | $206.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,752.26 / $13,496.75 / $22,212.50
| Facility | | $9,752.26 | $13,496.75 | $22,212.50 |