- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,887.71 / $13,562.00 / $28,340.00
| Facility | | $6,887.71 | $13,562.00 | $28,340.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,654.08 / $11,973.95 / $20,397.22
| Facility | | $6,654.08 | $11,973.95 | $20,397.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,647.61 / $12,660.47 / $20,413.50
| Facility | | $8,647.61 | $12,660.47 | $20,413.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,307.80 / $12,500.87 / $17,394.72
| Facility | | $7,307.80 | $12,500.87 | $17,394.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,540.70 / $25,540.70 / $29,974.18
| Facility | | $25,540.70 | $25,540.70 | $29,974.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $12,449.00 / $16,882.34
| Facility | | $1,787.00 | $12,449.00 | $16,882.34 |