- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,270.42 / $13,008.90 / $21,627.00
| Facility | | $9,270.42 | $13,008.90 | $21,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,542.68 / $11,708.98 / $17,444.72
| Facility | | $7,542.68 | $11,708.98 | $17,444.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,087.24 / $11,343.76 / $20,208.00
| Facility | | $8,087.24 | $11,343.76 | $20,208.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.96 / $118.96 / $188.71
| Facility | | $85.96 | $118.96 | $188.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,907.69 / $12,327.89 / $20,288.83
| Facility | | $8,907.69 | $12,327.89 | $20,288.83 |