- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.43 / $16,187.10 / $26,063.40
| Facility | | $7,079.43 | $16,187.10 | $26,063.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,141.42 / $14,141.42 / $14,141.42
| Facility | | $14,141.42 | $14,141.42 | $14,141.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $8,510.44 / $22,929.96
| Facility | | $1,474.01 | $8,510.44 | $22,929.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,547.00 / $16,031.01 / $23,975.86
| Facility | | $11,547.00 | $16,031.01 | $23,975.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,242.29 / $14,195.21 / $29,811.69
| Facility | | $10,242.29 | $14,195.21 | $29,811.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,616.45 / $14,195.21 / $30,196.61
| Facility | | $9,616.45 | $14,195.21 | $30,196.61 |