- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,223.00 / $15,016.00 / $25,458.40
| Facility | | $7,223.00 | $15,016.00 | $25,458.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,751.48 / $26,341.98 / $34,157.44
| Facility | | $17,751.48 | $26,341.98 | $34,157.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,646.00 / $20,430.66 / $32,666.49
| Facility | | $14,646.00 | $20,430.66 | $32,666.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,454.33 / $22,009.78 / $46,155.20
| Facility | | $11,454.33 | $22,009.78 | $46,155.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,021.92 / $6,021.92 / $8,650.83
| Facility | | $6,021.92 | $6,021.92 | $8,650.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,158.49 / $21,864.43 / $32,674.56
| Facility | | $16,158.49 | $21,864.43 | $32,674.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,870.00 / $16,763.00 / $28,102.14
| Facility | | $4,870.00 | $16,763.00 | $28,102.14 |