- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,002.70 / $16,843.09 / $24,866.00
| Facility | | $12,002.70 | $16,843.09 | $24,866.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,063.06 / $18,063.06 / $19,079.40
| Facility | | $18,063.06 | $18,063.06 | $19,079.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,579.34 / $15,000.08 / $21,745.50
| Facility | | $9,579.34 | $15,000.08 | $21,745.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,470.83 / $14,455.61 / $26,164.00
| Facility | | $10,470.83 | $14,455.61 | $26,164.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $111.30 / $153.31 / $244.33
| Facility | | $111.30 | $153.31 | $244.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,533.09 / $15,961.35 / $26,268.66
| Facility | | $11,533.09 | $15,961.35 | $26,268.66 |