- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,611.00 / $11,455.00 / $20,126.40
| Facility | | $5,611.00 | $11,455.00 | $20,126.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,765.89 / $18,943.71 / $24,564.16
| Facility | | $12,765.89 | $18,943.71 | $24,564.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,305.83 / $17,596.86 / $25,831.20
| Facility | | $12,305.83 | $17,596.86 | $25,831.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,055.34 / $17,400.05 / $36,488.46
| Facility | | $9,055.34 | $17,400.05 | $36,488.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,305.83 / $19,158.75 / $25,973.61
| Facility | | $12,305.83 | $19,158.75 | $25,973.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,870.00 / $14,839.53 / $22,747.10
| Facility | | $4,870.00 | $14,839.53 | $22,747.10 |