- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,549.20 / $14,432.50 / $25,397.00
| Facility | | $8,549.20 | $14,432.50 | $25,397.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,628.00 / $5,256.00 / $7,786.74
| Facility | | $2,628.00 | $5,256.00 | $7,786.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,150.39 / $11,961.18 / $19,787.07
| Facility | | $8,150.39 | $11,961.18 | $19,787.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,776.85 / $13,303.22 / $18,511.18
| Facility | | $7,776.85 | $13,303.22 | $18,511.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,055.55 / $28,055.55 / $32,925.57
| Facility | | $28,055.55 | $28,055.55 | $32,925.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $12,577.79 / $17,965.93
| Facility | | $1,787.00 | $12,577.79 | $17,965.93 |