- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,644.15 / $12,904.60 / $22,708.30
| Facility | | $7,644.15 | $12,904.60 | $22,708.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,312.45 / $7,312.45 / $13,170.00
| Facility | | $7,312.45 | $7,312.45 | $13,170.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,298.86 / $7,821.64 / $12,970.21
| Facility | | $5,298.86 | $7,821.64 | $12,970.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,953.55 / $11,894.88 / $16,735.18
| Facility | | $6,953.55 | $11,894.88 | $16,735.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,426.00 / $23,426.00 / $27,492.40
| Facility | | $23,426.00 | $23,426.00 | $27,492.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $11,251.00 / $16,063.96
| Facility | | $1,787.00 | $11,251.00 | $16,063.96 |