- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,401.69 / $17,422.09 / $22,747.00
| Facility | | $8,401.69 | $17,422.09 | $22,747.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,909.93 / $42,603.69
| Facility | | $5,840.42 | $15,909.93 | $42,603.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,844.06 / $16,277.36 / $24,595.29
| Facility | | $9,844.06 | $16,277.36 | $24,595.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,115.53 / $23,115.53 / $23,115.53
| Facility | | $23,115.53 | $23,115.53 | $23,115.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,183.36 / $16,397.97 / $25,322.32
| Facility | | $14,183.36 | $16,397.97 | $25,322.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,909.93 / $42,603.69
| Facility | | $5,840.42 | $15,909.93 | $42,603.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,909.93 / $33,295.16
| Facility | | $5,840.42 | $15,909.93 | $33,295.16 |