- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,135.34 / $11,742.00 / $18,906.00
| Facility | | $5,135.34 | $11,742.00 | $18,906.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,422.82 / $10,422.82 / $11,751.51
| Facility | | $10,422.82 | $10,422.82 | $11,751.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,354.09 / $16,486.96
| Facility | | $1,474.01 | $6,354.09 | $16,486.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,499.67 / $12,276.97 / $17,391.81
| Facility | | $8,499.67 | $12,276.97 | $17,391.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,429.64 / $10,297.04 / $25,725.00
| Facility | | $7,429.64 | $10,297.04 | $25,725.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,975.66 / $10,297.04 / $21,904.27
| Facility | | $6,975.66 | $10,297.04 | $21,904.27 |