- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,326.34 / $12,234.10 / $20,290.59
| Facility | | $9,326.34 | $12,234.10 | $20,290.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,952.00 / $11,952.00 / $11,952.00
| Facility | | $11,952.00 | $11,952.00 | $11,952.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,321.52 / $10,968.08 / $18,580.15
| Facility | | $7,321.52 | $10,968.08 | $18,580.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,534.58 / $13,035.68 / $18,743.72
| Facility | | $10,534.58 | $13,035.68 | $18,743.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,548.75 / $13,087.02 / $32,738.97
| Facility | | $6,548.75 | $13,087.02 | $32,738.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,548.75 / $12,495.02 / $17,561.13
| Facility | | $6,548.75 | $12,495.02 | $17,561.13 |