- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,980.57 / $13,559.40 / $20,382.00
| Facility | | $9,980.57 | $13,559.40 | $20,382.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,125.18 / $12,613.23 / $18,791.93
| Facility | | $8,125.18 | $12,613.23 | $18,791.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,706.75 / $12,020.19 / $21,756.00
| Facility | | $8,706.75 | $12,020.19 | $21,756.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92.55 / $127.48 / $203.17
| Facility | | $92.55 | $127.48 | $203.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,590.04 / $13,272.25 / $21,843.02
| Facility | | $9,590.04 | $13,272.25 | $21,843.02 |