- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,133.02 / $14,473.90 / $24,030.00
| Facility | | $9,133.02 | $14,473.90 | $24,030.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,743.00 / $3,743.00 / $3,743.00
| Facility | | $3,743.00 | $3,743.00 | $3,743.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,510.12 / $13,027.66 / $22,018.68
| Facility | | $8,510.12 | $13,027.66 | $22,018.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,476.01 / $15,821.48 / $27,632.36
| Facility | | $12,476.01 | $15,821.48 | $27,632.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,755.63 / $15,498.84 / $38,053.96
| Facility | | $7,755.63 | $15,498.84 | $38,053.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,226.00 / $13,992.39 / $20,531.93
| Facility | | $9,226.00 | $13,992.39 | $20,531.93 |