- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,275.34 / $14,602.20 / $24,243.00
| Facility | | $10,275.34 | $14,602.20 | $24,243.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,276.63 / $7,276.63 / $7,276.63
| Facility | | $7,276.63 | $7,276.63 | $7,276.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,269.24 / $10,680.00 / $18,050.78
| Facility | | $7,269.24 | $10,680.00 | $18,050.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,973.17 / $15,500.00 / $22,094.00
| Facility | | $11,973.17 | $15,500.00 | $22,094.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,824.38 / $14,961.46 / $31,196.41
| Facility | | $7,824.38 | $14,961.46 | $31,196.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,824.38 / $14,928.91 / $20,981.84
| Facility | | $7,824.38 | $14,928.91 | $20,981.84 |