- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,480.25 / $17,103.59 / $27,539.00
| Facility | | $7,480.25 | $17,103.59 | $27,539.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,291.53 / $11,291.53 / $11,291.53
| Facility | | $11,291.53 | $11,291.53 | $11,291.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,242.69 / $22,115.54
| Facility | | $1,474.01 | $6,242.69 | $22,115.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,380.80 / $17,882.91 / $25,333.29
| Facility | | $12,380.80 | $17,882.91 | $25,333.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,822.18 / $14,998.89 / $31,499.52
| Facility | | $10,822.18 | $14,998.89 | $31,499.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,160.90 / $14,998.89 / $31,906.24
| Facility | | $10,160.90 | $14,998.89 | $31,906.24 |