- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,645.80 / $14,938.90 / $22,067.00
| Facility | | $10,645.80 | $14,938.90 | $22,067.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,662.87 / $13,437.41 / $19,577.32
| Facility | | $8,662.87 | $13,437.41 | $19,577.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,287.04 / $12,821.32 / $23,206.00
| Facility | | $9,287.04 | $12,821.32 | $23,206.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $98.72 / $135.97 / $216.71
| Facility | | $98.72 | $135.97 | $216.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,229.20 / $14,156.82 / $23,298.82
| Facility | | $10,229.20 | $14,156.82 | $23,298.82 |