- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,728.94 / $17,862.40 / $23,970.00
| Facility | | $9,728.94 | $17,862.40 | $23,970.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,177.06 / $11,994.30 / $14,712.25
| Facility | | $9,177.06 | $11,994.30 | $14,712.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,141.70 / $13,803.78 / $20,400.98
| Facility | | $7,141.70 | $13,803.78 | $20,400.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,842.04 / $14,382.00 / $32,983.68
| Facility | | $8,842.04 | $14,382.00 | $32,983.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,435.58 / $13,960.13 / $20,069.59
| Facility | | $10,435.58 | $13,960.13 | $20,069.59 |