- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,244.62 / $11,365.40 / $18,869.30
| Facility | | $8,244.62 | $11,365.40 | $18,869.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,976.00 / $5,976.00 / $9,018.89
| Facility | | $5,976.00 | $5,976.00 | $9,018.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,092.01 / $10,856.74 / $18,294.14
| Facility | | $7,092.01 | $10,856.74 | $18,294.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,877.76 / $11,575.87 / $17,430.68
| Facility | | $8,877.76 | $11,575.87 | $17,430.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,090.00 / $12,170.26 / $31,712.67
| Facility | | $6,090.00 | $12,170.26 | $31,712.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,090.00 / $11,619.72 / $16,330.94
| Facility | | $6,090.00 | $11,619.72 | $16,330.94 |