- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,229.80 / $14,424.50 / $24,390.00
| Facility | | $11,229.80 | $14,424.50 | $24,390.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,581.00 / $12,723.00 / $15,840.69
| Facility | | $5,581.00 | $12,723.00 | $15,840.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,334.00 / $12,892.47 / $21,840.11
| Facility | | $8,334.00 | $12,892.47 | $21,840.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,420.71 / $15,369.61 / $22,099.63
| Facility | | $12,420.71 | $15,369.61 | $22,099.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,721.25 / $15,493.15 / $24,735.18
| Facility | | $7,721.25 | $15,493.15 | $24,735.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,721.25 / $14,732.15 / $20,705.30
| Facility | | $7,721.25 | $14,732.15 | $20,705.30 |