- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,385.88 / $10,364.40 / $16,540.00
| Facility | | $7,385.88 | $10,364.40 | $16,540.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,330.24 / $8,330.24 / $8,330.24
| Facility | | $8,330.24 | $8,330.24 | $8,330.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,011.74 / $9,332.40 / $14,841.78
| Facility | | $6,011.74 | $9,332.40 | $14,841.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,443.22 / $9,037.74 / $16,100.00
| Facility | | $6,443.22 | $9,037.74 | $16,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.48 / $99.49 / $159.75
| Facility | | $68.48 | $99.49 | $159.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,096.88 / $9,821.81 / $16,164.40
| Facility | | $7,096.88 | $9,821.81 | $16,164.40 |