- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,441.00 / $15,430.00 / $20,146.00
| Facility | | $7,441.00 | $15,430.00 | $20,146.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,908.72 / $37,732.19
| Facility | | $5,840.42 | $13,908.72 | $37,732.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,718.44 / $14,416.13 / $21,782.95
| Facility | | $8,718.44 | $14,416.13 | $21,782.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,472.39 / $20,472.39 / $20,472.39
| Facility | | $20,472.39 | $20,472.39 | $20,472.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,561.57 / $14,522.96 / $22,426.85
| Facility | | $12,561.57 | $14,522.96 | $22,426.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,908.72 / $37,732.19
| Facility | | $5,840.42 | $13,908.72 | $37,732.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $10,958.24 / $29,488.04
| Facility | | $5,840.42 | $10,958.24 | $29,488.04 |