- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $13,489.63 / $22,387.21
| Facility | | $8,912.51 | $13,489.63 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $9,549.93 / $9,549.93
| Facility | | $9,549.93 | $9,549.93 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $10,715.19 / $17,782.79
| Facility | | $7,762.47 | $10,715.19 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $10,000.00 / $12,882.50
| Facility | | $7,413.10 | $10,000.00 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $11,748.98 / $16,982.44
| Facility | | $7,413.10 | $11,748.98 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $11,220.18 / $15,488.17
| Facility | | $8,317.64 | $11,220.18 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $12,302.69 / $16,982.44
| Facility | | $4,168.69 | $12,302.69 | $16,982.44 |