- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,856.25 / $14,964.60 / $18,069.40
| Facility | | $7,856.25 | $14,964.60 | $18,069.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $13,512.75 / $22,865.54
| Facility | | $6,916.00 | $13,512.75 | $22,865.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,597.88 / $12,904.62 / $16,891.12
| Facility | | $11,597.88 | $12,904.62 | $16,891.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,800.61 / $11,254.65 / $14,647.60
| Facility | | $7,800.61 | $11,254.65 | $14,647.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,988.00 / $13,670.34 / $20,794.32
| Facility | | $7,988.00 | $13,670.34 | $20,794.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,671.10 / $12,018.11 / $15,895.46
| Facility | | $8,671.10 | $12,018.11 | $15,895.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $12,321.11 / $17,748.84
| Facility | | $3,775.00 | $12,321.11 | $17,748.84 |