- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,717.00 / $14,189.70 / $20,540.09
| Facility | | $9,717.00 | $14,189.70 | $20,540.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,325.45 / $11,338.93 / $12,944.83
| Facility | | $10,325.45 | $11,338.93 | $12,944.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,364.91 / $17,165.70 / $29,033.47
| Facility | | $6,364.91 | $17,165.70 | $29,033.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,871.14 / $14,252.77 / $23,855.92
| Facility | | $9,871.14 | $14,252.77 | $23,855.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,222.66 / $15,906.28 / $23,224.46
| Facility | | $12,222.66 | $15,906.28 | $23,224.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,222.66 / $14,787.01 / $23,224.46
| Facility | | $12,222.66 | $14,787.01 | $23,224.46 |