- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,223.78 / $12,905.90 / $16,850.40
| Facility | | $6,223.78 | $12,905.90 | $16,850.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $11,633.49 / $31,559.84
| Facility | | $5,840.42 | $11,633.49 | $31,559.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,292.25 / $12,057.90 / $18,219.63
| Facility | | $7,292.25 | $12,057.90 | $18,219.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,123.46 / $17,123.46 / $17,123.46
| Facility | | $17,123.46 | $17,123.46 | $17,123.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,506.71 / $12,147.25 / $18,758.20
| Facility | | $10,506.71 | $12,147.25 | $18,758.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $11,633.49 / $31,559.84
| Facility | | $5,840.42 | $11,633.49 | $31,559.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,750.00 / $24,664.29
| Facility | | $5,840.42 | $9,750.00 | $24,664.29 |