- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,499.08 / $11,227.00 / $19,632.09
| Facility | | $5,499.08 | $11,227.00 | $19,632.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,013.62 / $19,311.32 / $25,040.84
| Facility | | $13,013.62 | $19,311.32 | $25,040.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,460.53 / $17,570.40 / $25,190.60
| Facility | | $12,460.53 | $17,570.40 | $25,190.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,832.95 / $16,972.72 / $35,592.33
| Facility | | $8,832.95 | $16,972.72 | $35,592.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,694.00 / $7,694.00 / $7,694.00
| Facility | | $7,694.00 | $7,694.00 | $7,694.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,460.53 / $17,648.00 / $25,196.81
| Facility | | $12,460.53 | $17,648.00 | $25,196.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,870.00 / $14,475.09 / $22,188.46
| Facility | | $4,870.00 | $14,475.09 | $22,188.46 |