- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,728.94 / $18,100.70 / $23,633.00
| Facility | | $8,728.94 | $18,100.70 | $23,633.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,316.14 / $44,263.12
| Facility | | $5,840.42 | $16,316.14 | $44,263.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,227.49 / $16,911.37 / $25,553.29
| Facility | | $10,227.49 | $16,911.37 | $25,553.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,015.89 / $24,015.89 / $24,015.89
| Facility | | $24,015.89 | $24,015.89 | $24,015.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,735.81 / $17,036.68 / $26,308.64
| Facility | | $14,735.81 | $17,036.68 | $26,308.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,316.14 / $44,263.12
| Facility | | $5,840.42 | $16,316.14 | $44,263.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,854.96 / $34,592.01
| Facility | | $5,840.42 | $12,854.96 | $34,592.01 |