- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,733.07 / $19,124.09 / $33,777.00
| Facility | | $14,733.07 | $19,124.09 | $33,777.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,556.00 / $7,556.00 / $7,556.00
| Facility | | $7,556.00 | $7,556.00 | $7,556.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,535.56 / $17,280.95 / $29,274.29
| Facility | | $11,535.56 | $17,280.95 | $29,274.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,467.45 / $20,377.11 / $29,299.80
| Facility | | $16,467.45 | $20,377.11 | $29,299.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,845.42 / $19,574.54 / $51,582.46
| Facility | | $9,845.42 | $19,574.54 | $51,582.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,845.42 / $19,531.96 / $27,451.20
| Facility | | $9,845.42 | $19,531.96 | $27,451.20 |