- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,613.56 / $13,490.40 / $19,641.00
| Facility | | $9,613.56 | $13,490.40 | $19,641.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,965.01 / $9,965.01 / $9,965.01
| Facility | | $9,965.01 | $9,965.01 | $9,965.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,826.46 / $12,149.51 / $18,101.05
| Facility | | $7,826.46 | $12,149.51 | $18,101.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,386.59 / $11,578.19 / $20,956.00
| Facility | | $8,386.59 | $11,578.19 | $20,956.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.14 / $122.79 / $195.70
| Facility | | $89.14 | $122.79 | $195.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,237.40 / $12,784.21 / $21,039.82
| Facility | | $9,237.40 | $12,784.21 | $21,039.82 |