- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,175.00 / $17,476.50 / $21,102.50
| Facility | | $9,175.00 | $17,476.50 | $21,102.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $15,781.00 / $27,088.27
| Facility | | $6,916.00 | $15,781.00 | $27,088.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,659.40 / $15,070.77 / $18,796.36
| Facility | | $12,659.40 | $15,070.77 | $18,796.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,386.62 / $12,552.80 / $16,732.84
| Facility | | $8,386.62 | $12,552.80 | $16,732.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,589.06 / $16,191.00 / $24,980.40
| Facility | | $9,589.06 | $16,191.00 | $24,980.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,555.15 / $14,758.91 / $19,095.36
| Facility | | $10,555.15 | $14,758.91 | $19,095.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $14,389.34 / $20,728.16
| Facility | | $3,775.00 | $14,389.34 | $20,728.16 |