- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,419.38 / $13,311.50 / $17,380.00
| Facility | | $6,419.38 | $13,311.50 | $17,380.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $11,999.10 / $32,551.69
| Facility | | $5,840.42 | $11,999.10 | $32,551.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,521.43 / $12,436.85 / $18,792.23
| Facility | | $7,521.43 | $12,436.85 | $18,792.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,661.59 / $17,661.59 / $17,661.59
| Facility | | $17,661.59 | $17,661.59 | $17,661.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,836.91 / $12,529.00 / $19,347.72
| Facility | | $10,836.91 | $12,529.00 | $19,347.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $11,999.10 / $32,551.69
| Facility | | $5,840.42 | $11,999.10 | $32,551.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,750.00 / $25,439.43
| Facility | | $5,840.42 | $9,750.00 | $25,439.43 |