- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,375.00 / $15,952.70 / $19,262.50
| Facility | | $8,375.00 | $15,952.70 | $19,262.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $14,405.00 / $24,726.35
| Facility | | $6,916.00 | $14,405.00 | $24,726.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,054.60 / $13,913.74 / $17,640.59
| Facility | | $12,054.60 | $13,913.74 | $17,640.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,084.17 / $11,882.79 / $15,554.00
| Facility | | $8,084.17 | $11,882.79 | $15,554.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,822.29 / $14,731.88 / $22,691.75
| Facility | | $8,822.29 | $14,731.88 | $22,691.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,700.16 / $13,439.37 / $16,522.07
| Facility | | $9,700.16 | $13,439.37 | $16,522.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $13,134.68 / $18,920.80
| Facility | | $3,775.00 | $13,134.68 | $18,920.80 |