- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,967.20 / $12,626.30 / $20,962.59
| Facility | | $7,967.20 | $12,626.30 | $20,962.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,236.00 / $11,236.00 / $19,008.00
| Facility | | $11,236.00 | $11,236.00 | $19,008.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,519.05 / $11,263.98 / $19,081.41
| Facility | | $7,519.05 | $11,263.98 | $19,081.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,457.00 / $13,467.38 / $19,283.66
| Facility | | $10,457.00 | $13,467.38 | $19,283.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,765.63 / $13,520.43 / $33,622.21
| Facility | | $6,765.63 | $13,520.43 | $33,622.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,765.63 / $12,774.58 / $18,142.70
| Facility | | $6,765.63 | $12,774.58 | $18,142.70 |