- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,131.03 / $12,038.40 / $21,184.00
| Facility | | $7,131.03 | $12,038.40 | $21,184.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.00 / $5,840.00 / $5,840.00
| Facility | | $5,840.00 | $5,840.00 | $5,840.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,179.87 / $10,200.40 / $16,914.79
| Facility | | $7,179.87 | $10,200.40 | $16,914.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,486.79 / $11,096.42 / $15,872.28
| Facility | | $6,486.79 | $11,096.42 | $15,872.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,807.80 / $20,807.80 / $24,419.72
| Facility | | $20,807.80 | $20,807.80 | $24,419.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $10,491.32 / $14,985.65
| Facility | | $1,787.00 | $10,491.32 | $14,985.65 |