- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,190.33 / $11,960.30 / $15,720.00
| Facility | | $8,190.33 | $11,960.30 | $15,720.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,632.98 / $9,632.98 / $9,632.98
| Facility | | $9,632.98 | $9,632.98 | $9,632.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,285.21 / $6,223.49 / $10,526.20
| Facility | | $2,285.21 | $6,223.49 | $10,526.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,320.25 / $12,013.47 / $20,107.83
| Facility | | $8,320.25 | $12,013.47 | $20,107.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,302.32 / $13,407.19 / $19,575.59
| Facility | | $10,302.32 | $13,407.19 | $19,575.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,302.32 / $12,463.77 / $19,575.59
| Facility | | $10,302.32 | $12,463.77 | $19,575.59 |