- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,849.02 / $12,637.90 / $20,982.00
| Facility | | $9,849.02 | $12,637.90 | $20,982.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,681.08 / $9,504.00 / $11,482.92
| Facility | | $6,681.08 | $9,504.00 | $11,482.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,574.69 / $11,511.18 / $19,222.61
| Facility | | $7,574.69 | $11,511.18 | $19,222.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,893.51 / $13,479.82 / $19,382.34
| Facility | | $10,893.51 | $13,479.82 | $19,382.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,771.88 / $13,532.92 / $33,871.01
| Facility | | $6,771.88 | $13,532.92 | $33,871.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,771.88 / $12,920.74 / $18,159.46
| Facility | | $6,771.88 | $12,920.74 | $18,159.46 |