- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,731.10 / $14,579.10 / $22,955.70
| Facility | | $10,731.10 | $14,579.10 | $22,955.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,640.27 / $13,535.67 / $19,656.00
| Facility | | $8,640.27 | $13,535.67 | $19,656.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,361.48 / $12,924.08 / $23,392.00
| Facility | | $9,361.48 | $12,924.08 | $23,392.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $99.51 / $137.07 / $218.45
| Facility | | $99.51 | $137.07 | $218.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,311.19 / $14,270.29 / $23,485.57
| Facility | | $10,311.19 | $14,270.29 | $23,485.57 |