- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,002.60 / $15,432.60 / $25,621.80
| Facility | | $10,002.60 | $15,432.60 | $25,621.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,599.78 / $23,599.78 / $23,599.78
| Facility | | $23,599.78 | $23,599.78 | $23,599.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,068.62 / $13,585.33 / $23,013.83
| Facility | | $9,068.62 | $13,585.33 | $23,013.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,302.45 / $16,817.00 / $24,806.00
| Facility | | $13,302.45 | $16,817.00 | $24,806.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,269.37 / $16,525.52 / $40,551.29
| Facility | | $8,269.37 | $16,525.52 | $40,551.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,226.00 / $15,613.90 / $21,892.01
| Facility | | $9,226.00 | $15,613.90 | $21,892.01 |