- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,388.78 / $12,755.40 / $19,352.00
| Facility | | $9,388.78 | $12,755.40 | $19,352.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,992.00 / $13,368.95 / $17,947.88
| Facility | | $10,992.00 | $13,368.95 | $17,947.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,639.76 / $11,859.69 / $17,669.25
| Facility | | $7,639.76 | $11,859.69 | $17,669.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,190.49 / $11,307.47 / $20,466.00
| Facility | | $8,190.49 | $11,307.47 | $20,466.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.06 / $120.00 / $191.12
| Facility | | $87.06 | $120.00 | $191.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,405.15 / $12,966.23 / $19,116.27
| Facility | | $9,405.15 | $12,966.23 | $19,116.27 |