- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,207.42 / $10,798.30 / $14,422.00
| Facility | | $5,207.42 | $10,798.30 | $14,422.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,861.08 / $48,537.00
| Facility | | $5,840.42 | $9,861.08 | $48,537.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,101.41 / $10,016.83 / $15,244.32
| Facility | | $6,101.41 | $10,016.83 | $15,244.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,327.16 / $14,327.16 / $14,327.16
| Facility | | $14,327.16 | $14,327.16 | $14,327.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,790.94 / $10,163.57 / $15,694.94
| Facility | | $8,790.94 | $10,163.57 | $15,694.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,861.08 / $48,537.00
| Facility | | $5,840.42 | $9,861.08 | $48,537.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,733.71 / $22,982.42
| Facility | | $5,840.42 | $9,733.71 | $22,982.42 |