- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,108.60 / $17,065.00 / $30,029.50
| Facility | | $10,108.60 | $17,065.00 | $30,029.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,037.09 / $9,037.09 / $17,715.65
| Facility | | $9,037.09 | $9,037.09 | $17,715.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,484.60 / $16,813.93 / $27,800.92
| Facility | | $11,484.60 | $16,813.93 | $27,800.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,195.37 / $15,729.80 / $21,720.03
| Facility | | $9,195.37 | $15,729.80 | $21,720.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,560.55 / $32,560.55 / $38,212.57
| Facility | | $32,560.55 | $32,560.55 | $38,212.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $14,872.03 / $21,243.00
| Facility | | $1,787.00 | $14,872.03 | $21,243.00 |