- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,040.41 / $10,452.00 / $13,646.60
| Facility | | $5,040.41 | $10,452.00 | $13,646.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,544.82 / $25,559.16
| Facility | | $5,840.42 | $9,544.82 | $25,559.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,905.73 / $9,765.25 / $14,755.41
| Facility | | $5,905.73 | $9,765.25 | $14,755.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,867.66 / $13,867.66 / $13,867.66
| Facility | | $13,867.66 | $13,867.66 | $13,867.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,509.00 / $9,837.61 / $15,191.58
| Facility | | $8,509.00 | $9,837.61 | $15,191.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,544.82 / $25,559.16
| Facility | | $5,840.42 | $9,544.82 | $25,559.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,421.54 / $19,974.71
| Facility | | $5,840.42 | $9,421.54 | $19,974.71 |