- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,046.70 / $15,007.90 / $23,277.00
| Facility | | $11,046.70 | $15,007.90 | $23,277.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,991.46 / $13,902.99 / $20,229.59
| Facility | | $8,991.46 | $13,902.99 | $20,229.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,636.82 / $13,304.20 / $24,080.00
| Facility | | $9,636.82 | $13,304.20 | $24,080.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.43 / $141.10 / $224.87
| Facility | | $102.43 | $141.10 | $224.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,614.46 / $14,690.00 / $24,176.32
| Facility | | $10,614.46 | $14,690.00 | $24,176.32 |