- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,880.00 / $15,009.80 / $18,124.00
| Facility | | $7,880.00 | $15,009.80 | $18,124.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $13,553.60 / $23,264.91
| Facility | | $6,916.00 | $13,553.60 | $23,264.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,629.82 / $12,982.31 / $16,925.40
| Facility | | $11,629.82 | $12,982.31 | $16,925.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,386.42 / $10,827.72 / $14,055.15
| Facility | | $7,386.42 | $10,827.72 | $14,055.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,109.12 / $13,725.03 / $20,740.50
| Facility | | $8,109.12 | $13,725.03 | $20,740.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,866.04 / $12,246.09 / $15,697.32
| Facility | | $8,866.04 | $12,246.09 | $15,697.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $12,358.36 / $17,802.50
| Facility | | $3,775.00 | $12,358.36 | $17,802.50 |