- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,436.60 / $14,178.90 / $19,465.00
| Facility | | $10,436.60 | $14,178.90 | $19,465.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,255.43 / $13,129.32 / $19,189.14
| Facility | | $8,255.43 | $13,129.32 | $19,189.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,104.54 / $12,569.38 / $22,750.00
| Facility | | $9,104.54 | $12,569.38 | $22,750.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $96.78 / $133.30 / $212.45
| Facility | | $96.78 | $133.30 | $212.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,028.20 / $13,878.64 / $22,841.00
| Facility | | $10,028.20 | $13,878.64 | $22,841.00 |