- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,807.60 / $18,712.59 / $31,067.30
| Facility | | $11,807.60 | $18,712.59 | $31,067.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,486.00 / $7,486.00 / $7,486.00
| Facility | | $7,486.00 | $7,486.00 | $7,486.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,749.64 / $16,456.00 / $27,813.07
| Facility | | $10,749.64 | $16,456.00 | $27,813.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,129.63 / $20,454.83 / $35,724.55
| Facility | | $16,129.63 | $20,454.83 | $35,724.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,643.45 / $20,037.71 / $48,068.16
| Facility | | $9,643.45 | $20,037.71 | $48,068.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,643.45 / $19,131.28 / $26,888.07
| Facility | | $9,643.45 | $19,131.28 | $26,888.07 |