- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,095.09 / $11,977.70 / $21,077.30
| Facility | | $7,095.09 | $11,977.70 | $21,077.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,628.00 / $11,793.32 / $32,414.27
| Facility | | $2,628.00 | $11,793.32 | $32,414.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,934.55 / $8,759.98 / $14,484.13
| Facility | | $5,934.55 | $8,759.98 | $14,484.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,454.10 / $11,040.51 / $15,811.85
| Facility | | $6,454.10 | $11,040.51 | $15,811.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,851.12 / $48,537.00 / $48,537.00
| Facility | | $10,851.12 | $48,537.00 | $48,537.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,520.00 / $11,389.34 / $22,147.00
| Facility | | $2,520.00 | $11,389.34 | $22,147.00 |