- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,527.13 / $14,924.30 / $24,030.00
| Facility | | $6,527.13 | $14,924.30 | $24,030.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,211.01 / $11,211.01 / $11,211.01
| Facility | | $11,211.01 | $11,211.01 | $11,211.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,242.69 / $20,080.74
| Facility | | $1,474.01 | $6,242.69 | $20,080.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,803.28 / $15,604.32 / $22,105.39
| Facility | | $10,803.28 | $15,604.32 | $22,105.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,443.25 / $13,087.77 / $27,485.94
| Facility | | $9,443.25 | $13,087.77 | $27,485.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,697.10 / $12,711.63 / $23,595.71
| Facility | | $8,697.10 | $12,711.63 | $23,595.71 |