- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,328.35 / $13,122.70 / $17,133.59
| Facility | | $6,328.35 | $13,122.70 | $17,133.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $11,828.95 / $32,090.10
| Facility | | $5,840.42 | $11,828.95 | $32,090.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,414.77 / $12,260.49 / $18,525.75
| Facility | | $7,414.77 | $12,260.49 | $18,525.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,411.16 / $17,411.16 / $17,411.16
| Facility | | $17,411.16 | $17,411.16 | $17,411.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,683.24 / $12,351.34 / $19,073.37
| Facility | | $10,683.24 | $12,351.34 | $19,073.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $11,828.95 / $32,090.10
| Facility | | $5,840.42 | $11,828.95 | $32,090.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,750.00 / $25,078.70
| Facility | | $5,840.42 | $9,750.00 | $25,078.70 |