- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,166.69 / $11,268.70 / $18,859.90
| Facility | | $8,166.69 | $11,268.70 | $18,859.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,546.59 / $17,546.59 / $17,546.59
| Facility | | $17,546.59 | $17,546.59 | $17,546.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $12,762.78 / $19,656.75
| Facility | | $2,423.00 | $12,762.78 | $19,656.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,358.54 / $12,677.81 / $21,260.62
| Facility | | $8,358.54 | $12,677.81 | $21,260.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $10,231.70 / $22,751.36
| Facility | | $2,600.00 | $10,231.70 | $22,751.36 |