- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,710.00 / $15,639.80 / $20,556.09
| Facility | | $10,710.00 | $15,639.80 | $20,556.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,899.34 / $12,899.34 / $17,333.29
| Facility | | $12,899.34 | $12,899.34 | $17,333.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,457.88 / $17,587.24 / $29,746.45
| Facility | | $6,457.88 | $17,587.24 | $29,746.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,879.90 / $15,709.29 / $26,293.81
| Facility | | $10,879.90 | $15,709.29 | $26,293.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,471.73 / $17,531.78 / $25,597.83
| Facility | | $13,471.73 | $17,531.78 | $25,597.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,471.73 / $16,298.13 / $25,597.83
| Facility | | $13,471.73 | $16,298.13 | $25,597.83 |