- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,634.11 / $16,017.30 / $29,383.00
| Facility | | $9,634.11 | $16,017.30 | $29,383.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,184.30 / $15,184.30 / $15,184.30
| Facility | | $15,184.30 | $15,184.30 | $15,184.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,873.42 / $14,221.67 / $21,562.98
| Facility | | $8,873.42 | $14,221.67 | $21,562.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,027.35 / $12,675.33 / $21,699.49
| Facility | | $7,027.35 | $12,675.33 | $21,699.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,027.35 / $13,462.93 / $21,130.19
| Facility | | $7,027.35 | $13,462.93 | $21,130.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,560.79 / $17,415.88 / $33,287.00
| Facility | | $8,560.79 | $17,415.88 | $33,287.00 |