- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,426.00 / $10,377.40 / $18,563.00
| Facility | | $4,426.00 | $10,377.40 | $18,563.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,904.64 / $17,665.66 / $22,906.93
| Facility | | $11,904.64 | $17,665.66 | $22,906.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,203.84 / $15,798.36 / $22,650.03
| Facility | | $11,203.84 | $15,798.36 | $22,650.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,942.11 / $15,260.96 / $32,002.72
| Facility | | $7,942.11 | $15,260.96 | $32,002.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,203.84 / $17,067.37 / $22,655.62
| Facility | | $11,203.84 | $17,067.37 | $22,655.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,485.89 / $13,968.00 / $19,950.66
| Facility | | $4,485.89 | $13,968.00 | $19,950.66 |