- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,070.00 / $11,768.80 / $19,104.40
| Facility | | $8,070.00 | $11,768.80 | $19,104.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,740.57 / $11,740.57 / $11,740.57
| Facility | | $11,740.57 | $11,740.57 | $11,740.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,924.02 / $25,481.68 / $32,668.82
| Facility | | $17,924.02 | $25,481.68 | $32,668.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,476.08 / $18,321.11 / $23,172.88
| Facility | | $9,476.08 | $18,321.11 | $23,172.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,419.70 / $12,656.50 / $20,238.20
| Facility | | $8,419.70 | $12,656.50 | $20,238.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,846.75 / $16,079.48 / $25,287.35
| Facility | | $9,846.75 | $16,079.48 | $25,287.35 |