- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,432.53 / $17,486.00 / $22,830.50
| Facility | | $8,432.53 | $17,486.00 | $22,830.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,762.10 / $42,760.09
| Facility | | $5,840.42 | $15,762.10 | $42,760.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,880.20 / $16,337.12 / $24,685.58
| Facility | | $9,880.20 | $16,337.12 | $24,685.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,200.39 / $23,200.39 / $23,200.39
| Facility | | $23,200.39 | $23,200.39 | $23,200.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,235.43 / $16,458.16 / $25,415.29
| Facility | | $14,235.43 | $16,458.16 | $25,415.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,762.10 / $42,760.09
| Facility | | $5,840.42 | $15,762.10 | $42,760.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,418.45 / $33,417.39
| Facility | | $5,840.42 | $12,418.45 | $33,417.39 |