- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,185.00 / $13,127.10 / $26,677.80
| Facility | | $10,185.00 | $13,127.10 | $26,677.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,492.27 / $8,492.27 / $8,492.27
| Facility | | $8,492.27 | $8,492.27 | $8,492.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,561.25 / $13,238.75 / $15,135.31
| Facility | | $10,561.25 | $13,238.75 | $15,135.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,129.84 / $14,390.66 / $18,715.68
| Facility | | $8,129.84 | $14,390.66 | $18,715.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,766.11 / $9,766.11 / $9,766.11
| Facility | | $9,766.11 | $9,766.11 | $9,766.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $11,540.96 / $17,773.36
| Facility | | $1,286.00 | $11,540.96 | $17,773.36 |