- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,713.57 / $13,196.70 / $18,863.00
| Facility | | $9,713.57 | $13,196.70 | $18,863.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,908.61 / $12,277.03 / $18,291.04
| Facility | | $7,908.61 | $12,277.03 | $18,291.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,473.83 / $11,698.64 / $21,174.00
| Facility | | $8,473.83 | $11,698.64 | $21,174.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.07 / $124.07 / $197.73
| Facility | | $90.07 | $124.07 | $197.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,856.03 / $12,900.26 / $20,477.38
| Facility | | $8,856.03 | $12,900.26 | $20,477.38 |