- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,559.23 / $9,639.76 / $14,883.00
| Facility | | $6,559.23 | $9,639.76 | $14,883.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,421.63 / $12,421.63 / $12,421.63
| Facility | | $12,421.63 | $12,421.63 | $12,421.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,486.45 / $19,173.00 / $24,580.78
| Facility | | $13,486.45 | $19,173.00 | $24,580.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,382.18 / $14,272.75 / $18,052.45
| Facility | | $7,382.18 | $14,272.75 | $18,052.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,559.23 / $9,859.79 / $15,766.20
| Facility | | $6,559.23 | $9,859.79 | $15,766.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,670.94 / $13,117.41 / $19,929.16
| Facility | | $7,670.94 | $13,117.41 | $19,929.16 |