- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,588.64 / $13,662.50 / $17,838.30
| Facility | | $6,588.64 | $13,662.50 | $17,838.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,315.50 / $33,410.01
| Facility | | $5,840.42 | $12,315.50 | $33,410.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,719.76 / $12,764.79 / $19,287.74
| Facility | | $7,719.76 | $12,764.79 | $19,287.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,127.31 / $18,127.31 / $18,127.31
| Facility | | $18,127.31 | $18,127.31 | $18,127.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,122.66 / $12,859.37 / $19,857.89
| Facility | | $11,122.66 | $12,859.37 | $19,857.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,315.50 / $33,410.01
| Facility | | $5,840.42 | $12,315.50 | $33,410.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,750.00 / $26,110.23
| Facility | | $5,840.42 | $9,750.00 | $26,110.23 |