- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,349.87 / $14,519.00 / $23,377.40
| Facility | | $6,349.87 | $14,519.00 | $23,377.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.00 / $10,964.00 / $17,995.45
| Facility | | $10,964.00 | $10,964.00 | $17,995.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $7,981.09 / $20,467.86
| Facility | | $1,474.01 | $7,981.09 | $20,467.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,509.88 / $15,180.54 / $21,505.06
| Facility | | $10,509.88 | $15,180.54 | $21,505.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,186.79 / $12,732.34 / $26,739.48
| Facility | | $9,186.79 | $12,732.34 | $26,739.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,625.44 / $12,732.34 / $27,084.74
| Facility | | $8,625.44 | $12,732.34 | $27,084.74 |