- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,424.21 / $18,118.80 / $39,465.00
| Facility | | $12,424.21 | $18,118.80 | $39,465.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,067.65 / $7,067.65 / $7,067.65
| Facility | | $7,067.65 | $7,067.65 | $7,067.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,460.32 / $16,013.08 / $26,545.60
| Facility | | $10,460.32 | $16,013.08 | $26,545.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,601.80 / $19,305.93 / $27,918.00
| Facility | | $15,601.80 | $19,305.93 | $27,918.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,698.75 / $19,498.37 / $36,537.00
| Facility | | $9,698.75 | $19,498.37 | $36,537.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,698.75 / $18,545.56 / $26,008.17
| Facility | | $9,698.75 | $18,545.56 | $26,008.17 |