- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,025.00 / $15,286.00 / $18,457.50
| Facility | | $8,025.00 | $15,286.00 | $18,457.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $13,803.00 / $23,693.01
| Facility | | $6,916.00 | $13,803.00 | $23,693.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,824.94 / $13,196.41 / $17,134.88
| Facility | | $11,824.94 | $13,196.41 | $17,134.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,002.60 / $11,701.80 / $15,303.20
| Facility | | $8,002.60 | $11,701.80 | $15,303.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,232.21 / $14,076.60 / $21,128.04
| Facility | | $8,232.21 | $14,076.60 | $21,128.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,012.26 / $12,412.41 / $16,150.56
| Facility | | $9,012.26 | $12,412.41 | $16,150.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $12,585.77 / $18,130.08
| Facility | | $3,775.00 | $12,585.77 | $18,130.08 |