- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,182.00 / $15,440.30 / $24,860.80
| Facility | | $3,182.00 | $15,440.30 | $24,860.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,063.04 / $13,702.47 / $16,057.46
| Facility | | $9,063.04 | $13,702.47 | $16,057.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $10,088.21 / $21,786.35
| Facility | | $1,474.01 | $10,088.21 | $21,786.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,176.76 / $15,291.34 / $22,869.61
| Facility | | $11,176.76 | $15,291.34 | $22,869.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,172.75 / $16,519.93 / $28,436.17
| Facility | | $9,172.75 | $16,519.93 | $28,436.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,172.75 / $16,519.93 / $24,411.46
| Facility | | $9,172.75 | $16,519.93 | $24,411.46 |