- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,091.82 / $11,666.30 / $19,368.90
| Facility | | $9,091.82 | $11,666.30 | $19,368.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,976.00 / $5,976.00 / $7,920.00
| Facility | | $5,976.00 | $5,976.00 | $7,920.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,077.40 / $10,834.38 / $18,190.81
| Facility | | $7,077.40 | $10,834.38 | $18,190.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,056.01 / $12,752.55 / $19,059.00
| Facility | | $10,056.01 | $12,752.55 | $19,059.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,251.25 / $12,492.50 / $31,647.36
| Facility | | $6,251.25 | $12,492.50 | $31,647.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,251.25 / $11,927.39 / $16,763.34
| Facility | | $6,251.25 | $11,927.39 | $16,763.34 |